Busy day it was today! Barely made time to write this email, but I just couldn’t let it slide. We got in late yesterday from our road trip from New York. Later than we originally intended, but the weather for most of the ride was horrendous!
 
Gales of wind and constant rain, ranging from drizzling to downpours from New York through most of South Carolina, for two full days, with hours-long, bumper-to-bumper traffic through Baltimore, Washington and almost all of Virginia. It was moving at a crawl. 
 
Have I ever mentioned I don’t do well with frustration?
 
I could’ve let the bride drive, but although she’s a much better driver than I am in daylight, in poor weather and worse visability–not so much. So, for self-preservation’s sake, I did it. But I didn’t like it. Well, who would? 
 
I guess we figured that all the folks that had travelled to visit their families for Thanksgiving had already gone home. WRONG! We won’t make that assumption again.
 
Well, I did get a chance to try out a few of the tips I’ve always passed on to my patients over the years. Last email, I mentioned the quad setting and butt tightening exercises that help to dispell knee pain.  They really do work. But, when you’re jammed in a car with less leg room than you’d like, although you can manage it for your left leg, it’s much tougher with the right. You just can’t get enough room to straighten it out.
 
So, here’s what I did, that helped. I noticed that the constant ache in my left knee (from being kept bent for hours) was a function of a slight outward twist on the joint line, that varied with my foot position. I tended to rest my foot with my heel inward and my toes outward on the gas pedal, which produced an ache at the medial (inner front) joint line of the knee. 
 
But when I reversed this twist, there was dramatic knee pain relief. I just turned my foot slightly, so the heel was outward, against the central wall of the driver’s side leg compartment, and the toes were relatively turned inward, still on the pedal. The pain was remarkably reduced, because the twist of the end of the femur (thigh bone) on the upper tibia (shin bone) was reversed. 
 
This simple maneuver, combined with frequent pit stops, helped me get through. 
 
The other problem was a tension headache, from wretched visibility, wet roads, high speed traffic (interspersed with HOURS of nearly standing still, that set my teeth on edge) and the usual collection of idiots, that seem to have no appreciation of the laws of physics and always seem to be next to me. I can feel the tightening of my trapezius muscles at the base of my skull.
 
ZOOOOM! Pouring rain, slick roads, huge volumes of spume, spraying off the 18 wheeler trucks right onto my windshield and some imbecile in a bright yellow pickup truck flashes past me, so close he almost left a streak of yellow on my door! Why should I be surprised? Who in the world drives a bright YELLOW truck–on purpose? You want to be SURE the cops can identify you? Well, no accounting for taste….
 
Anyway, you can’t do the rotating your head thing at 70 mph. But what helps is one of those neck pillows they sell for about 20 bucks, to use on airline flights.  They’re light weight, soft and they can be propped up behind your neck for support and blessed relief of stress.
 
Needless to say, whenever we stopped, I’d take the chance to do my knee exercises, like those I teach in my PAIN-FREE PROGRAM. See it yourself at   http://drbillsclinic.com/exercise_eliminate.html 
 
The next day, the sun was shining, there was a mild temperate breeze; in short, it was beautiful. So the bride got to take us on home, a little later than we planned, but hey, we made it. That’s what counts.  I can hardly wait to do it all over again next weekend.  I must be out of my mind….
 
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

After my heartrending session at the vets yesterday morning, I was pretty down. I’d lost a loving companion of 13 years and even though I really had no choice and it was the right thing to do, it was painful. I didn’t feel much like doing anything. I’m a pretty upbeat, positive and basically optimistic person (you kind of have to be, to be a surgeon–part of the job description), but like everyone else, I have my moments of gloom, especially when I have a good reason.
 
Well, despite feeling beat up (emotional stuff has always knocked the crap out of me, whatever it is), rather than mope around feeling sorry for myself, I decided to take some positive action. First, I practiced some controlled, deep breathing, even while driving. It’s amazing what a simple thing like deep breathing can do for your mental and emotional state.
 
It has a calming, rejuvinating effect. And it helps you get and maintain some emotional control, when you’re upset. By taking control of your breathing, you seize the initiative in your life. Oddly enough, it really helps in times of trouble.

Next, I drove to the local mall, where I did a number of rapid walking circuits around the entire mall, alternating both floors. This was not only good exercise, dialing up my heartbeat, stimulating my metabolism and promoting even more deep breathing, but the constant activity, the background chatter, the continually changing venue, as I passed all the different store fronts, were sufficiently distracting, so I couldn’t focus on my loss.
 
Then, I spent time doing a number of the specially modified knee exercises that I teach in my PAIN-FREE PROGRAM, which you can see for yourself at http://drbillsclinic.com/exercise_eliminate.html
 
By the time I was done with all that, I felt much calmer and much more in control. I was still sad, of course, but it’s amazing what a little exercise and deep breathing will do for you–it’s the best cure for what ails you. It brightens your outlook, brings you back into the flow of life, and even provides much needed perspective. Lots of benefits, just from getting your blood pumping.
 
Later on, I checked my email and I was really moved by the number of subscribers that took the time and trouble to write me, with support and sympathy. It really meant a lot and I deeply appreciate it. It’s nice to know there are folks out there who understand, who’ve been through this themselves. It helps…it really does.
 
By way of appreciation, I’m passing on to you that my pal, Dr. Dharma, The World’s #1 Brain Longevity Expert, is having a special Election Day Sale on his Brain Longevity Supplements. You can do something to protect your memory, and your personality from the ravages of Alzheimer’s with these nutrients–I use them myself. And now you can save a pile of cash, too. It won’t last, though, so go on over to  http://drbillsclinic.com/brain_longevity.html  NOW, and get while the gettin’ is good.
 
And speaking of Election Day, if you haven’t yet, get out and VOTE. People have fought and died to give you the right to choose your own future. You don’t have the right to complain, after the fact, if you don’t vote, now. Regardless of who you support, make your voice heard.
 
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

You may have noticed that yesterday’s email was a bit late–like, it wasn’t broadcast until after midnight, which pissed me off to no end. Fortunately, that was just after midnight EDT, and many of my subscribers reside all over the world, in other time zones. So only the east coast people were affected. But it was still mega annoying.
 
Thing was, I had it written and ready to go much earlier in the day, but my terrific merchant service, 1shoppingcart was on the fritz. “Error” kept coming up, every time that I clicked on the appropriate button and tried to send the email. Very frustrating, to say the least. So I saved my work, by clicking on “save draft.” And then, clicked off, hoping that whatever the problem was would be resolved with a little time.
 
Later, about 11PM my time, I logged back in, clicked on the “saved drafts” button, so I could retrieve the email and send it off, and guess what? The damn thing had ERASED 80% of my email! AAAAARRRRGGHHH!  I HATE when that happens! Must have been gremlins in the shopping cart….
 
Anyway, I had to rewrite nearly the whole damn thing again, from memory. Luckily, my memory isn’t shot just yet I was retyping frantically, with my rudimentary hunt and peck skills, re-saving every paragraph or so, just to be on the safe side. And I finished before midnight. YEAAA! Only, the line-up of others ahead of me pushed its transmission to after the witching hour. C’est la guerre….
 
Well, I guess I should be thankful that this doesn’t happen ALL the time. Anyway, when I was so rudely interrupted by the gremlins, I was telling you about my friend, who had recurrent knee pain. He initially had a very good response to the specially modified knee exercises I teach in my PAIN-FREE PROGRAM, at http://drbillsclinic.com/exercise_eliminate.html
 
But, like many people, he felt so good, he became lax and gradually stopped doing them. After all, he felt good, no pain, so the knee must be OK, right?
 
Err….no, sorry. The problem he had was a chronic degenerative condition. And that doesn’t disappear, just because you’ve compensated for it and relieved the resultant pain. So, absent the beneficial effects of exercise, the kneecap gradually fell back into the  abnormal tracking pattern that caused his problem to start with. Whether his actual disease was chondromalacia, or osteoarthritis of the patellofemoral compartment, the final result was recurrent anterior knee pain. 
 
As I mentioned, there are two fundamental components to treating this condition: 1.exercise and 2.measures to reduce inflammation. And they must be addressed simultaneously. 
 
Fortunately, there are many ways to combat inflammation. Conventional conservative treatments, home remedies, over the counter medications (with proper precautions), as well as a number of proven alternative treatments, which work by different mechanisms, can have a  synergistic effect to relieve knee pain. I cover a number of these, with specific instructions how to use and combine them, in my newest healing program,  HOW TO AVOID KNEE SURGERY, which you can get at http://drbillsclinic.com/avoid_knee_surgery.html
 
Long term, there is no better treatment than exercise.  That’s why I include a Baker’s Dozen of the most effective, proven knee exercises and stretches in this new program, as well. Or you can get the full range of exercises and stretches in the PAIN-FREE PROGRAM, at   http://drbillsclinic.com/exercise_eliminate.html  But either way, exercise is key in getting and maintaining complete pain relief and restoration of full knee function. 
 
If he follows my advice, my friend should get relief of his recurrent knee pain in short order, probably less than seven days. But to keep it, he’s got to do the work…and keep doing it.
 
You can get away with a lot and slack off when you’re young. Young tissues are forgiving. But as you age, more conscientious efforts are required. If you don’t do the necessary work, you will pay the price. It’s as simple as that.
 
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

About seven months ago, now, I wrote you about one of the girls that works in the salon, where I get my hair cut. Her name is Nanetta, and she’s a nice, attractive, middle aged, fairly tall and big boned, broad shouldered woman, a bit overweight for her size, perhaps, but not too bad. 
 
Well, last March, I wrote about her complaints of knee pain, mainly in the anterior compartment (the front of the knee). It was my feeling that she probably had some chondromalacia patellae, a degenerative softening of her retropatellar cartilage. That’s the usual cause of anterior knee pain, though not the only cause. 
 
I had though that was what she had, though, because she also had difficulty climbing stairs, both pain and weakness. Generally, when you have weakness of your quadriceps muscles associated with kneecap pain, chondromalacia is a good bet. You can learn more about CMP and the other causes for knee pain at   http://drbillsclinic.com/eliminate_knee_pain.html
 
In any case, I started her on some of the basic knee exercises that I teach in my PAIN-FREE PROGRAM at
 http://drbillsclinic.com/exercise_eliminate.html
 
Yesterday, since I had a little free time and since I was beginning to look “shaggy,” I decided to visit the local salon for a trim. As it happened, Nanetta was on duty and said she could take me right then, if I’d come straight over. So, I did.
 
After the usual pleasantries we exchanged, she got down to it. While she was restoring my tonsorial contours, we chatted about this and that. Then, I asked her, “So, how are your knees doing?”
 
And she replied, “You know, I hadn’t thought about it, but they haven’t bothered me for a couple of months now.”
 
“No kidding?’ I said. “Well did they just get better on their own, or did you actually DO what I told you to do?”
 
“No, I really DID do the exercises you gave me,” she said. “They were really tough, at first, even the basic ones. But then, they started to get easier and the pain just went away. In fact, I hadn’t even thought about the pain until you asked me about it.”
 
“Well, I guess the stuff works, huh?” I said.
 
“Yeah, it really does. Thanks so much. I feel much better now…”
 
So here we have it, my friend, “living proof” that the exercises from my PAIN-FREE PROGRAM are safe and effective. They’re specially modified to prevent or eliminate knee pain of all types. And they’re “field tested,” because they’re drawn from the same exercises I used to treat my own patients, and those I used on my own knees, too. They worked for Nanetta’s knees and they’ll work for yours, as well. Just click on this link for your own copy:    http://drbillsclinic.com/exercise_eliminate.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

Besides the fact that I am a hip & knee specialist, albeit retired from active practice, the reason that I decided to focus on knee productsfor the start of my “second career” on this web site is that knee pain seems to be a very common, nearly universal problem, especially in people of my age group, The Boomers.  It happens almost every day–someone will mention that they have a painful knee, or they have arthritis, or they have a knee that “gives out,” or some other problem. It doesn’t get the “press” that back pain does, but everybody seems to have it, in one form or another.
 
Hell, I’ve had it myself–as many of you know. There’s nothing quite like having the same problem as your patients to give you a whole new appreciation of what they’re going through. They call that empathy. When I had my arthroscopic surgery on April 15, 2000 (Tax Day–might as well get all the agony over with at one time), believe me, I had a brand new understanding of what all my patients over the years had been experiencing. 

The need for the surgery, as you might expect, was well documented by physical exam, and a positive MRI, that demonstrated a torn medial meniscus. It had been interfering with my walking and exercising and I had just had enough. I called two of my best buds in the Department; one was busy and didn’t return my call, but the other saw me right away. Hey, rank has its privileges, right? Well, he agreed that I needed the ’scope. So we booked it for the local Surgi-Center, which specializes in outpatient surgeries.
 
So on the big day, they rolled me into the OR, smiles all around. They started an IV and slipped me a little IV Versed (a short acting relaxant that has the side effect of short term amnesia). Very relaxing, almost pleasurable. I remember just a tiny stab of sharp pain in my left knee, where I needed a little more local anesthetic, otherwise, nothing. Woke up gradually in recovery, feeling fine. If you ever need to have surgery, this is called “conscious sedation” and it’s definitely the way to go.
 
As soon as I woke up sufficiently, they let me go and I went home. Set myself up in bed with my leg well elevated, with a big bag of crushed ice on it, to reduce swelling. At first, I was quite comfortable…then, the local anesthetic, injected into the knee at surgery, wore off. Oh boy! That was sore and even worse when I had to put it down to limp to the bathroom on crutches. So THAT’S what they were all complaining about. I suspected that MY surgeon had given me less anesthetic than I gave my patients. Took at least 2-3 days, before I could put some pressure on it.
 
Turns out I had a whole lot more pathology in that knee than I initially thought. That’s the thing about MRI’s and other interpretive examinations: the real thing is always worse than the scan indicates. In my case, a small area of bare bone under the residual meniscal rim, in other words, some arthritis. Now, with time, and me doing my own therapy, with the same exercises I teach at http://drbillsclinic.com/exercise_eliminate.html   I gradually improved, more and more.
 
But after my left knee recovered, the right started acting up. I thought about going through the same process that I had just finished on my left knee, and decided that the odds were good that I had a “mirror image” lesion (in other words, the very same pathology) in my right knee. THIS time, I opted to AVOID SURGERY and treated myself with all the various options I knew about from across the entire treatment spectrum: the best of conventional therapy, alternative measures, dietary changes, nutriceuticals, the works.

And it’s worked–so far, I haven’t had to have surgery on my right knee. And these same measures are those that I used for the over 90% of my patients, who I was able to treat without surgery. Now, I’ve put all these strategies and a number of healing programs into my newest product: HOW TO AVOID KNEE SURGERY. Go see it at    http://drbillsclinic.com/avoid_knee_surgery.html
Get rid of 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

 With gas prices reaching stratospheric levels, and no end in sight, the geniuses in Congress continue their obdurate blindness, in blind obeisance to radical environmentalists. This, in open defiance of the American people, the majority (57% last poll) of whom want us to drill and exploit our own resources (before they’re sucked out from under us by foreign powers, notably the Chinese, Cubans, Indians, Vietnamese and others).

Now, as I’ve said before, I’m all for sensible, rational conservation measures–with a finite resource, it just makes sense–and I like breathing clean air as well as the next guy. I’m also a big fan of new technology for alternative energy–all for it (for example, all the hot air generated in Congress is currently wasted…).
 
But the RADICAL elements, who if they dared tell the truth, want us all back in horses and buggies and want to damage capitalism and our economy, care more about the caribou than the people who need oil, to heat their homes in winter and gas, to drive to work and diesel, to deliver our groceries. BTW, the caribou actually LOVE the oil pipelines, where they exist–turns out they’re warm, so they attract the caribou, who have increased their numbers by mating in proximity to the same dreaded pipelines. 
 
Then, there are the national defense implications. Do we really want to become a third world power? No other nation on earth refuses to use its own natural resources. How arrogant to go to the Saudis (who are not our friends, despite lip service–remember how many of the 9/11 hijackers were Saudis) and demand that THEY increase their production for our benefit, when we refuse to do so. Wouldn’t it be cool to be able to give these regimes in the Middle East “the finger,” instead of our money? And since a part of that money finds its way into the coffers of jihadists and terrorists who want to KILL us, wouldn’t it make sense to deprive them of at least our share of those funds?
 
I think so. 

Newt Gingrich, of American Solutions, has started a campaign to lobby Congress to DRILL HERE. DRILL NOW. PAY LESS. Whatever you think of his politics, at least he’s proposing a positive course of action. He has over 650,000 signatures on his petition, so far. In response to this, demonstrating a breathtaking dearth of intellect and lack of common sense, Congressional Democrats have been on every talk show saying, “We can’t drill our way of this!” And because we’re largely a nation of government educated fools, they get away with that nonsense.
 
Yes, if we started drilling today, it would be years before we actually got the oil on line (more reason to start right now, says I). BUT, and it’s a big ”but,” the speculators (who everyone is blaming for this crisis) would see we were serious and the oil prices would fall down to where the actual forces of supply and demand would determine the price–around $80 a barrel, not bumping $140.
 
Just today, President Bush has called for Congress to expand domestic oil production by a four step plan. This would include drilling on the Outer Continental Shelf (OCS), which if we don’t do, others will (see above), ANWR, exploitation of Colorado oil shale, similar to the oil sands of our Canadian cousins, which would produce, conservatively, over 800,000,000,000 barrels of oil, and increasing refining capacity by construction of new refineries. And that doesn’t count the huge amounts of natural gas that we have….or energy from modern nuclear power plants.
 
OK. Let’s look at this rationally, devoid of emotion or political perspective. The only reasons NOT to drill are environmental, right? People concerned about the environment are worried about oil spills, or nuclear waste or nuclear meltdowns, ala Chernobyl. But their concerns are based on technology and conditions from three decades ago. Again, emotion, not intellect. 

So let’s drill now, with environmental oversight, and conditional approval–to be withdrawn if the energy companies fail to keep their promises of respect for the land and the wildlife. Simultaneously, let’s promote all the alternative energy sources we can develop for now and the future. Let’s face it–fossil fuels are on their way to becoming the whale oil of this era.
 
Honda’s already advertising their hydrogen powered fuel cell car (in my opinion, the real answer–hydrogen is the most plentiful element in the universe and the fuel cells produce only water vapor as exhaust). Toyota has a plug-in electric car that reportedly can hit 100 mph. Ford and other companies have hybrids already available. 

I’ve been driving Mercedes-Benz since 1984. And my other car is a Mercedes, too. But I’ve had it with these outrageously expensive gas hogs! I’m seriously thinking about a Prius–45-60 mpg looks pretty good right about now. And I’m going to get back into riding a bicycle, for short hops. Not only is that a great way to improve my circulation and condition my heart, but it will strengthen my knees, as well. Between that and the special knee exercises from my PAIN-FREE PROGRAM at  http://drbillsclinic.com/exercise_eliminate.html
I can keep my knees in good shape and help the environment, too. And so can 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

Today, being Friday the 13th, the temptation to write about this being an unlucky day is strong. Ever since the success of The DaVinci Code, pretty much everyone had heard of one of the origins of the superstition, the arrest of the Knights Templar by King Philip IV of France throughout Europe on Friday 13th, 1307, on trumped up charges (because he was deeply in debt to the Order).
Well, I’M BORED WITH IT! I mean, everyone does that. If I read one more blog about Friday the 13th, I think I’ll scream.
 
I’d rather tell you about my Dad, in honor of Fathers’ Day, this coming Sunday. I think that’s a more positive topic than yet another musing on a stupid superstition. Well, it’s my choice isn’t it? So, I will.
 
My dad was born Thomas William Stillwell (they christened me William Thomas, because both Mom and Dad didn’t like “juniors” for some reason. Go figure). He was raised in Dyker Heights in Brooklyn, New York. He finished High School and was reportedly a terrific baseball player (I was awful), who actually played semi-pro ball for a minor league team, the Adanacs (an anagram of Canada–no idea why). He was raised a Baptist, but later was a Methodist Episcopalian for a while, and eventually became an Episcopalian, when I was confirmed. He was actually a member of the Vestry (the lay governing body) at Christ Church, Bay Ridge in Brooklyn, during my teen years. 

He joined the Navy at the start of the Second World War, and qualified for the Submarine Service, which required special training. He was a Machinist’s Mate on the USS DACE and served in the Pacific theatre for the duration of the War. I’ve written before about his stories of
sweating out Japanese depth charge attacks, while submerged. And he had shore leave in Honolulu, Hawaii,  judging by some girlie pictures of Hawaiian girls in grass skirts and lais (and not much else) my brother found in his effects.
 
He met my mother when she was only 18, though she looked more mature. They got married shortly thereafter, while he was still in the Service, but I didn’t come along for three years. They made a really handsome couple, judging from the old black and white photographs that remain.
 
Like every couple, they had their issues from time to time, but as a boy growing up, I never knew that. They gave me a wonderful childhood, full of love and support, although I was reportedly quite a handful, starting out as a colicky baby and rapidly emerging as a precocious (some might say obnoxious) child. They both encouraged a lifelong love of education. After age seven, Mom was just living for the day I would be a doctor, but Dad always said, “If you graduate from college, I know you’ll do well in life, no matter what you do, and I’ll have done my job.” No one was happier than Dad when I became the first college graduate in the family.
 
It always bothered him that he never went to college, even though everyone who met him always assumed that he had. If he put on a suit, he looked like an executive, and he was by nature a very intelligent man. But he had a streak of the gambler in him–when my mother thought he was going to night classes, he was actually going to see the ponies. But he never bet the mortgage, or compromised our budget.
 
In fact, for most of my life, Dad worked three jobs,  so he could keep meat on the table every day. He had a day job, that could best be described as middle management, he did income taxes, and he sold real estate. I didn’t realize how big a burden that was when I was
growing up–like most kids, I was completely self-absorbed and didn’t really appreciate what was being done for me, quietly and without fanfare, every day.  But I do now. His family was the most important thing in his world and he just did whatever was necessary to provide for us. Quite a guy.
 
Dad only hit me twice in my life–and I deserved it, both times. The first was when, despite instructions to go to sleep, my brother and I kept on making a racket, fighting with each other. My brother instigated it, but I got caught retaliating. Dad came up and whacked me once.  It always annoyed me that my brother was responsible, but I got punished. In any case, Dad was pi$$ed. The second time was when I was age 16 and I smart mouthed my mother, in front of Dad. I didn’t curse or anything (I wouldn’t dare!), I just had a real smarta$$, mouth on me, lightning quick and hurtful, and pretty disrespectful. My remark had barely left my mouth, when I saw a blur out of the corner of my eye. CRACK! Right across my mouth, with his open hand–he said, “Don’t you EVER talk to your mother like that in front of me. She may be your mother, but she’s MY WIFE!” I was more shocked, than hurt. And then, ashamed. To this day, I remember that lesson–and I really respect my father for teaching me. And that was it. The rest of the time, a look from him or a “talking to” was sufficient.
 
Dad was happy when I graduated from Medical School, though he said, “This is really for your mother. I was happy with college.” The important thing is, he was always there, in quiet support, to provide for me, guide me, and just to be there for me. He was always there to talk to, to give me advice and to teach me how a MAN takes care of his family. While I was always grateful for him, I didn’t really appreciate him, until years later.
 
Just before my wedding, I remember him taking me aside and warning me that my bride-to-be was a beautiful girl, but she had “Mercedes taste,” so I’d better hold on to my wallet. Man, he had THAT right! Ironically, he was the one member of my family that my new wife really liked. But Dad was like that–everybody loved the guy.
 
I lost Dad just four months later. He had been at the beach with Mom and a bunch of the younger kids from the extended family. It had been a beautiful day, by all reports. Dad wanted to keep up with the kids in a  swimming race, thinking he was still that young athlete,
playing baseball. He came out, said he was tired, and then, his eyes just rolled up in his head and down he went. It was painless; he apparently had a ventricular arrhythmia, where the heart begins to writhe, instead of beat, and cardiac output stops. It’s like someone just turned out the light–too fast for a heart attack to develop. So, at least there’s that….
 
I had a post mortem done, so we’d know what happened.  Turns out all those unfiltered cigarettes, Old Gold, Camels, Chesterfields during the War, and the later Kent Light 100 Kingsize (his idea of “cutting back”) took their toll. He had one single blockage at the base of the Left Anterior Descending Artery (LAD) of the heart.  He was two weeks short of his 54th birthday. My brother and I have never smoked….
 
So I remember Dad fondly, with much love and deep appreciation, this Fathers’ Day. He taught me much, but most of all, what it means to meet responsibilities, what it means to be a man. I am what I am, largely because of him. And there’s no one who would have enjoyed my success in life more….
 
So this Fathers’ Day, my wife’s father is still with us, soon to be 84. We plan to visit and take him out to dinner for the day. I actually operated on him back in the early eighties, for a torn meniscus. Found a pretty good amount of arthritis in there, too. And this was before arthroscopic techniques were introduced.  I started him on the selected knee exercises I teach at
 http://drbillsclinic.com/exercise_eliminate.html    And he’s doing pretty well. He still follows my advice about using a cane to unload his joint and enhance his stability (when he feels like it). He had his heart worked on last year (coronary bypass and aortic valve 
replacement) and came through it fine. Tough guy, as I’ve said before. Probably bury us all…. 

Well, my friend, if it applies to you, Happy Fathers’ Day. May your children love and appreciate you, as I love and appreciate my Father and my Father-in-Law.  It’s the hardest job in the world to do well. Til next time, be well.
 
Yours for a pain-free tomorrow,

Dr. Bill

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

Today, my father-in-law, Charlie, is coming over to visit us, but if truth be told, he’s probably coming over to get away from the chaos in his own house, too.  Charlie’s will be 84 his next birthday and a tougher, more self-reliant guy you’ll never meet. He’s on his third wife (having buried the other two), who was also previously married. She has a daughter, now divorced, and two granddaughters, all of whom are living with her and Charlie in a house he built with his own two hands, only a couple of years ago, if you can believe it. On the one hand, they wait on him hand and foot. But three women under one roof, yelling and screaming at each other (did I mention they’re of Italian extraction?) drives him nuts. Hence, the need for a break…
 
Charlie, like many of us, is frustrated as hell at the limitations age imposes on us all. He’s a very physical guy, whose sole goal in daily life was to get up and “have a productive day.” And produce, he did. 

He was a bona fide member of the “Greatest Generation,” volunteering to join the Navy in WW II at age 17. He lied about his age to get into the service (just like the 17 year olds today!). He saw action on LST’s (flat bottomed amphibious landing crafts) and then joined the Air Force Reserve after the War, to complete 20 years of service to the nation. Then, he put in the next 50 years as a general contractor and mason. He built homes and office buildings and small shopping centers, mostly with his own two hands and a few paid by the day bricklayers and helpers. And his brickwork and stonework were just spectacular–and self-taught.

Though only about 5 foot seven, pound for pound, I never met anyone stronger than Charlie. Once, in the mid-1980′s, my wife and I, Charlie and my brother-in-law were trying to leave New York City, for Long Island, by way of the Queens Midtown Tunnel, when our SUV threw a bolt and stopped dead in the street, blocking traffic at the entrance. Charlie put up the hood and took a look (I was clueless–hey, I was a surgeon, not a mechanic!). Then, he jumped UNDER the hood, and with one arm, HE LIFTED THE ENTIRE ENGINE BLOCK, while he rethreaded and spun the nut onto the bolt with the other hand! This, like it was nothing. Then, he jumped out, with his arm still  smoking from the hot engine block, just swiped at the blisters on his forearm. “Ahh, this is nothin’,” he said. Second degree burns and he just blew them off.

This was just one of the nearly superhuman feats of strength that I saw over the years. The guy lived to work. If he was too full of energy at night, he’d go out and shovel a ton of sand, or dig a foundation, by hand, with a shovel, just for exercise. No exaggeration. Just shaking hands with this guy was like putting your mitt in a vice. Unbelievable. Luckily, he always liked me.
 
As it happens, I operated on Charlie’s knee over 25 years ago, for a torn meniscus. At that time, there were no arthroscopic techniques, so it was an “open” procedure (arthrotomy), although it was only about  1 – 1/2 inches long in a gentle “S” curve (this serves to give greater exposure; it has nothing to do with “branding” my patients with the Stillwell “S”, contrary to popular belief). I saw some arthritis in there, too, and I was sorely tempted to debride it, drill it, try to smooth it out, and in general, “polish the apple” a bit. 

My assistant and friend, Steve, told me, “Bill, just leave him alone. Don’t mess with it. You’ll just make him worse.” So, I did as he bade me. You see, knowing my tendency to be a perfectionist, I asked Steve to assist me, ’cause he had very good judgment. We agreed that if we had differing opinions during the case, his call would rule. And he was right. It’s tough to be objective when it’s friend or family, so I substituted
HIS judgment for mine, while I was able to execute my own technical facility for the surgery. 

The combination worked. It’s been well over a quarter century and Charlie still hasn’t needed a total knee replacement.  He did great after surgery, using the foundational knee exercises that eventually evolved into my PAIN-FREE PROGRAM (which you can see at
 http://drbillsclinic.com/exercise_eliminate.html )  He would have done even better, faster, had it been five years later, after the arthroscopic techniques had been introduced.
 
Today, his back is shot; he’s paying the price for the excessive stresses he loaded on it for all those years. And he walks with a cane. Like the rest of us,  Charlie isn’t quite what he once was, but he’s still one helluva really tough guy in my book. So I think we’ll go out for dinner and take it easy. It’s been a tough week. We can all use a break. Til next time, my friend, be well. 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

 Last week, I got an email from an old friend and patient of mine that she and her husband would be visiting the Orlando area this week, as they were staying at a local time share, near Sea World. She wanted to know if we could all get together for dinner this week. So last night was the night.
 
Now this lady, a lovely woman who was a teacher, was one of my very first patients in private practice.  I opened my doors in August of 1979 and I first met her in 1980. She had been badly injured in an auto accident, and was originally told that she would lose her leg and possibly her life. She had a severe fracture of the upper three inches of the tibia, or shin bone. Now this is a tough injury to treat, regardless of the method used, because the hamstring and biceps femoris tendons are attached to that fracture fragment. So these tendons tend to pull back on the small upper wafer of bone, making it very difficult to control and therefore, very difficult to set straight (ie., reduce). 

Added to these technical problems was the fact that right behind her fracture were all the big blood vessels and nerves, on their way down to the lower leg. So the potential for nerve or blood vessel injury, or even clots in the veins (deep vein thrombosis), was very real. To cap it all off, she was very high strung and very anxious and she didn’t want surgery, nohow–period!
 
Fortunately, I was young enough to still be in my “there’s nothin’ I can’t do” phase. I honestly believed, with all my heart, that I could do almost anything and pull it off ( I smile, with the acquired wisdom of a lot more years, at my niave belief in my own invincibility, at that time). So, despite the fact that this fracture should probably have been treated surgically, I proceded to treat her in accordance with her wishes, with closed methods: multiple, repetitive castings, with x-rays. Had she met me ten years later, when I was a lot more experienced and a good deal wiser, I would have insisted on surgery and talked her into it. 

As it was, against all odds, I was successful. As I always say, “Better lucky than smart!” But she did indeed heal in virtually perfect alignment, meaning that the upper tibial plateau healed perpendicular to the long axis of the rest of the tibia and parallel to the ground. Because of the pull of those muscles, however, which could not be overcome with just a cast, that upper sliver of tibia had displaced backward, about an inch — what we call “lightning bolt” apposition.
 
Well, she recovered, got her motion and function back, and did really well for over 20 years, until the year 2000. By that time, she had developed end stage arthritis in that knee and finally needed her knee replaced. So conservative measures bought her two decades, before surgery was finally needed. The total knee replacement was uneventful and clinically, she’s done really well.

Over the years, she’s evolved from patient to friend.  Whenever I was giving a talk, or running a public forum,  I could always count on this lady and her husband, also a retired teacher, to be right there in the front row,  for moral support and as “living proof.” So, it was really great to see them again. We talked and laughed about old times and people we knew. They wouldn’t allow me to pay anything toward the meal, either. My wife and I had just a wonderful time.
 
On the way out of the restaurant, I asked her, “So,  how’s the knee?” “Okay,” she said, somewhat guardedly.  Hmmm. Further questioning found some aching and she admitted she has some trouble getting out of a chair.  Turns out, she hasn’t seen anyone for followup since my retirement and, even more important, she hasn’t been doing any knee exercises, like she’d been taught.  Oh, when the cat’s away….
 
Anyway, I advised her to work on strengthening her quads, especially with quarter squats and half squats, and wall sitting, just like the exercises I teach at   http://drbillsclinic.com/exercise_eliminate.html     And she can recapture more flexion by sitting and going back and forth in a rocking chair. I made sure to go over this with her husband, to be sure she’ll really do them. And I gave her a good doc, to followup
with, since I’m out of action. Hell, if she gets her strength back, she’s likely to make it for the duration with her first knee replacement and never need another.
 
So, all in all, a good night and a wonderful time. It’s good to see old friends and remember past glories. It helps to remember what it was all for…and that it was well worth 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