February 1, 2010

Worked my butt off this past weekend, cleaning the house for an anticipated visit by my father-in-law’s wife’s brother and his wife, from Italy. Seems the guy is reported to be allergic to cats. Heh. That would make ours the wrong house to visit, as a general rule (we’re down to 24 now, having just lost Misty, our oldest, on this past Christmas Eve Day).
 
But, as these nice folks have never been in the States before, in the interests of international diplomacy, we decided to go the extra mile and super clean the place to make it “safe” for an allergy sufferer.
 
But first, we had to trap the cats and confine them. Otherwise, you’re just spinning your wheels. Fortunately, like me and most of our friends, they’re “food sluts.” Nothing they wouldn’t do, no place they wouldn’t go, for a tasty meal. So, my wife and I cracked open a few cans of wet cat food and played “Pied Piper” with them.
 
It’s quite a sight to see them all following the aroma of the food, right into the bedrooms, where we locked them in for the day. Then, we could work in peace.
 
So, we finished the house and then set about making some food. One thing about Italians is that they know good food. So we pulled out all the stops.  Turned out pretty well, too. They seemed to like everything and had seconds….
 
Nice couple they were: Mario and Tina. Live near Naples (the real one, not the one in Florida), have four kids, the oldest of whom is now in his forties. And they speak no English. Fortunately, Anna, Charlie’s wife and Mario’s sister, is bilingual, so we had our own built-in interpreter. Very lovely people. And we had a good time.
 
During the meal, Mario mentioned to my father-in-law that his son was supposed to have surgery on his knee. Between Anna’s interpretations and sign lingo, I was made to understand that he was having arthroscopic surgery on his lateral mensicus, which according to an MRI scan, was torn. And, since he found out that I was an orthopaedic surgeon, he naturally wanted to know if I thought that surgery was necessary.
 
Pretty good question, really. I pointed out to him that if he had read my book on treating knee pain, DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  http://www.drbillsclinic.com/eliminate_knee_pain.html  he would know the answer. And a lot has to do with the nature of the tear, where in the meniscus it is, and how active he intends to be after surgery. And all that is assuming that the tear actually exists.
 
The MRI scan is a great tool for diagnosis. On the medial side of the joint (inner side), its accuracy is about 90-95%. But, because of the screwy anatomy of the lateral compartment of the knee joint, MRI findings of the lateral meniscus are only about 60% accurate. So, actual pathology has to confirmed at arthroscopy, before you can begin to decide on appropriate treatment.
 
Apparently, he got the injury playing football. Not our idea of football, as in the Superbowl, but European football, or soccer. The rapid twisting, cutting movements in that game result in lots of meniscal tears. And, despite his age, he’d like to continue playing, after the proposed procedure. That being the case, he SHOULD have the surgery. 
 
If he was a low demand user, ie., a couch potato, then the same injury need not be treated so aggressively. In fact, the pain could then be treated with a number of the non-surgical options that I recommend, from across the entire medical spectrum, including the best alternative treatments, in my newest healing program, HOW TO AVOID KNEE SURGERY: http://www.drbillsclinic.com/avoid_knee_surgery.html  
 
The exercises I show you, plus one, or several, of the other simple, easy to apply solutions for knee pain, including the anti- inflammatory properties of my POWERHOUSE OMEGA FORMULA,  http://www.favoriteformulas.com    an ultra pure, pharmaceutical grade fish oil, can often get rid of your knee pain fast and keep it gone, for good. Two capsules, twice a day, for a couple of months should do the trick, by reducing inflammation.
 
He felt very reassured that his son was making the right decision. And he was relieved that he had every reason to believe that his recovery would be fast and uneventful. Especially after I told him that I’d had such surgery myself and obviously, did well.
 
Then, it was time for them to make the run to the Orlando International Airport. Another of his sons was flying in to visit and they were going to pick him up. Naturally, they all want to go to Disney World.
 
So, having done our bit for U.S. international relations, and made two new friends, we all said “Ciao!” and bid them farewell. After a few well-earned moments of peace, for ourselves, the bride and I released the feline hordes, who descended on the kitchen, looking for more food!  There’s no end to it!
 
And, you know, that guy, Mario, never sneezed once! Guess we did a pretty good job. Well, that’s it for today, my friend. 
 
Remember that very soon, now, I will be asking you to sign up again, if you’d like to continue getting my daily emails and commentary, when I switch to a new server to improve email reliability and delivery. I know it’s a pain in the butt, but it’s necessary. 
 
On the other hand, if you’d like to bail, but were afraid of hurting my feelings, just don’t do anything and that will be done for you–you’ll just stop getting these daily ramblings and musings. To continue, you will have to take action, when the time comes.
 
Anyway, be well. Talk to you soon. 

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

January 28, 2010

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

January 26, 2010

I got an email from a friend of mine, about someone with a peculiar hip pain. Seems this guy had a sudden onset of a popping over the outer aspect of his hip, when he twisted. This was accompanied by pain down the back of his thigh. Naturally, he was concerned. So my friend asked me what I thought.
 
Well, y’know, there are always a number of conditions that can cause a similar pattern of symptoms. But it’s an old, but true saying popular in medical circles: “When you hear hoofbeats, don’t think of zebras.” Meaning, of course, that the most common cause is usually the answer.
 
In this case, the guy probably had an acute onset of ITB (iliotibial band) tendinitis. The ITB is a thick, wide fibrous band that runs down the side of the leg, like a wide tuxedo stripe, from the pelvis and the abductor muscles at the side of the hip, overlying that lump of bone that you probably call your “hip bone,” and I call the greater trochanter.
 
If this band was injured, or irritated, perhaps by a minor bump, now forgotten, that minor injury might have been sufficient to provoke the cell-mediated, delayed inflammation I spoke about yesterday. Then, the tissues can become swollen and thicker than normal, causing the band to impinge on the underlying lump of bone (which is all “trochanter” really means). Any twisting or torsional movement would then cause the band to snap or pop over the trochanter, like plucking a banjo string.
 
The resultant pain would follow the path of the anatomy, down the side of the leg. Not uncommonly, its back edge is the most tender, hence the pain “down the back of the leg.” This can sometimes mimic sciatica, though that is usually NOT accompanied by sound effects, nor is it provoked by twisting motions at the hip. And true sciatica is often a severe, burning pain, often accompanied by numbness, or muscular weakness, or even reduced or absent reflexes in the distribution of specific nerve root(s). From the description, this man had something quite diffferent.
 
And this particular condition (ITB Tendinitis) can be double trouble, as well. Wherever the pain starts, it can also cause pain at its other end, where it crosses the outer aspect of the knee joint, to insert on the small bump of bone at the outer, upper tibia (shin bone), called Gerde’s Tubercle. 
 
So it’s not uncommon to see hip AND knee pain from this entity. That’s the probem with a long structure that crosses two joints–it can cause pain anywhere along its entire length and at both ends, as well.  

So, what to do?
 
Fortunately, the same measures are effective whatever part of the ITB is inflamed. So treatments intended for the knee ARE effective for symptoms from the hip and vice versa. Here are a few helpful things you can do for relief:
 
First, you need to avoid any activities that aggravate the structure and cause the popping. 
 
Second, relieve stress and tension on the band, by using a cane in the hand opposite the affected side. 
 
Third, rest with your hips apart (abducted). A good way to do this is to put a couple of pillows between your knees. 
 
If you must sit, do so on a pillow, or gel pad, as the greater trochanters roll backwards when you sit and if you sit on a hard chair, that can actually cause pain and just make things worse. 
 
If symptoms have just started, ice the tender area a few times a day. 
 
After the first 48 hours, switch to moist heat. 
 
Reduce inflammation short term, by using Advil or Aleve. BUT, you must take these NSAID drugs with food, to protect your stomach from side effects, which include gastritis, reflux, ulcers and bleeding. 
 
Long term, I’d recommend a high quality pharmaceutical grade fish oil, like my POWERHOUSE OMEGA FORMULA, http://www.favoriteformulas.com   which lacks any significant side effects, but has potent, proven anti-inflammatory properties. Once the “fire” is out, you can then begin gentle stretching and strengthening exercises for the ITB, like those I teach in my PAIN-FREE PROGRAM, available here at:  http://www.drbillsclinic.com/exrrcise_eliminate.html
 
As with any tendon problem, healing is slow, because the iliotibioal band is mainly fibrous tissue, which has a very poor blood supply. So slow and steady progress, without repetitive aggravation of symptoms, is the way to go. I’ve had this particular condition myself, so I know these measures work. You just need patience and “tincture of time.” Til next time, my friend, be well.  Talk to you soon.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
“The Wellness Warrior”        TM
 
(Be sure to sign up for my Podcasts at iTunes, or http://thewellnesswarrior.mypodcastworld.com)
 
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

January 25, 2010

Over the weekend, I got an email from a subscriber who complained of a very common problem. So, I thought I’d pass it along, as you may well have, or have had, this same problem yourself.
 
He wrote that he had developed a pop or snapping sensation inside his knee, which had cause him to start having pain, when bending or straightening the joint. He didn’t recall any specific injury to the knee.
 
That’s not at all uncommon, you know. Many is the time that patients came to see me in the office with an obvious injury, yet they couldn’t remember any such trauma in the recent past. In these cases, what I surmised is that they had a minor injury, perhaps a bump into the corner of a piece of furniture, not bad enough to remember, so it didn’t register. 
 
But over a few days, the incident now forgotten, the body set up a “delayed” inflammation, mediated by a cellular response. From the standpoint of the patient, this pain seemed to come out of the blue. But there really WAS an injury–just not one they could recall.
 
I’ve had this happen, myself. It was only when I really made the effort to remember and retrace my steps that I finally recalled the minor bump, several days before, that was the cause of the pain. That’s more likely to happen, now that I’m back on my POWERHOUSE OMEGA FORMULA  http://www.favoriteformulas.com
 
The pharmaceutical grade fish oil has real anti-coagulant properties, among others, like preventing heart attacks and strokes, anti-inflammatory properties, and many others. While that’s usually a good thing, preventing abnormal clots and deep vein thrombosis, the price you pay is a greater tendency to bruise, which is simply bleeding under the skin.
 
Blood in the tissues is a common cause for delayed inflammation and resultant pain. In this case, this person likely had a bruise, which he no longer recalls, which then set up the inflammation, which then resulted in inflammation of the synovial membrane, that lines the knee. 
 
The synovium normally has a few small folds from birth. When these folds are swollen from inflammation, they enlarge into plicae(meaning “folds” in Latin). These plicae can then snap, or pop, as they are rubbed against the bony contours of the end of the femur, within the knee. In effect, they are plucked, like the strings of a guitar, when bending or extending the knee.
 
If the inflammation is chronic, lasting for an extended period of time, the synovial membrane may be replaced by thick, fibrous tissue, thereby becoming a stiff cord of scar. Once that happens, that plica is there for good. It can only be removed by surgery. 
 
Prior to that, however, the irritated and swollen fold in the membrane can be shrunk, by using one, or several, of the many            non-surgical treatments in my newest healing program, HOW TO AVOID KNEE SURGERY http://www.drbillsclinic.com/avoid_knee_surgery.html 
 
In the short term, ice applications, for the first 24-48 hours helps, because the cold constricts the blood vessels, thereby limiting the amount of bleeding and swelling in the injured tissues. After that, intermittent heat is more beneficial. 
 
How do you know when to switch?
 
See how it feels. If heat makes the knee hurt more, then it still needs ice. If, on the other hand it feels good, then heat is what’s needed. Like we used to say in the 60′s and 70′s: “If it feels good, do it.”
 
And, though this may seem like just common sense, you should NOT continue to snap the knee. Continually “plucking the string” will only prolong the ongoing inflammation, maintaining the swelling of the tissues and preventing resolution. To keep the knee still, you may need to place it in a knee immobilizer, which will hold it straight, while still allowing weight bearing.
 
If you follow these few tips and use the methods I outline in HOW TO AVOID KNEE SURGERY, http://www.drbillsclinic.com/avoid_knee_surgery.html  and you will get fast relief, shrink the plica and get rid of that irksome, snapping knee pain. Til next time, my friend, be well. Talk to you again, soon.
 
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

January 21, 2010

The other day, I got another email from one of my subscribers, who had an interesting, but not uncommon story. Seems he had knee pain located right on his inner (medial joint line). He saw his doctor, and was sent for an MRI.
 
Sure enough, he had a torn medial meniscus. He also had some degenerative changes (read that as “early arthritis”), not uncommon in a middle aged guy. His question for me was, do I REALLY need to have an arthroscopic surgery? 
 
He was understandably reluctant to go “under the knife,” and was hoping that I could give him some less aggressive treatments that would relieve his pain, but help him avoid surgery. He also didn’t understand why these structures simply didn’t heal.
 
So, I tried to explain. I used to have to do this a dozen times a week, in my practice–meniscal injuries were the second most common cause of knee pain that I saw, after kneecap problems. So here’s the short story.
 
In each knee, there are two crescent shaped fibrocartilage structures that guide and cushion the knee in motion. They help to spread out the stresses of weightbearing over a larger surface area, kind of the way snowshoes work to keep you from sinking into a snow bank.
 
I have a great illustration of this principle in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN http://www.drbillsclinic.com/eliminate_knee_pain.html  which I drew myself. (I used to work for the comics as an artist, back in the 70′s.) 
 
Here’s the thing he didn’t understand, though, that makes all the difference: These structures are mostly avascular. That means that they mostly lack a blood supply. There is virtually no circulation within these cartilage cushions, at least in the inner 2/3 to 3/4. There IS a marginal circulation at the periphery, where the medial (but NOT the lateral) meniscus attaches to the fibrous capsule of the knee joint.
 
If a tear occurs within this so-called “red zone,” it does have the potential to heal. But only 10% of tears occur there. The remainder occur in the avascular part, and therefore CANNOT heal (at least not without fairly sophisticated surgical help), because nothing heals without blood. 
 
This anatomical fact governs the behavior of meniscal tears AND determines what constitutes effective treatment.
 
Given that he has a positive MRI, he probably SHOULD have an arthroscopic examination. If pathology is confirmed at surgery, it can be fixed on the spot. This is a prime example of what I like to call a NECESSARY surgery. And, it’s a simple, outpatient procedure, with a fairly rapid recovery. I know. I’ve not only done thousands of them, but I’ve had the surgery myself, too.
 
Had he presented with the same pain pattern, but NOT had an MRI, I probably would have urged him to try the non-surgical treatments I teach in my healing program, HOW TO AVOID KNEE SURGERY, which you can get here:
 http://www.drbillsclinic.com/avoid_knee_surgery.html
 
With methods from across the entire medical spectrum, including many effective alternative treatments, it can provide relief of pain and help you avoid surgery, in many cases. 
 
In this way, if pain is relieved, you’ve avoided an UNNECESSARY surgery. If not, you’ve “burned no bridges” and can still get an MRI and if that is positive, arthroscopy, if needed. But it gives your knee a chance to heal itself.
 
Except in case of a completely locked knee, which is a surgical emergency, it can buy you time, perhaps heal you, and you lose nothing. 
 
For other causes of knee pain, like chondromalacia patellae, or arthritis of the knee, it may be definitive treatment. I teach you how to relieve pain fast, but also how to stay pain-free for the long term, with special, modified exercises and the anti-inflammatory properties of my pharmaceutical grade fish oil, DR. BILL’S POWERHOUSE OMEGA FORMULA:   http://www.favoriteformulas.com 
an ultra pure, highly concentrated omega 3 formulation, with a special enteric coating that prevents virtually all the fishy aftertaste and fish burps that plague other, lesser brands. 
 
But in this man’s case, he already had a demonstrated, through and through tear in the avascular zone. The probablity of healing was poor to none. And further delay would accomplish nothing good, but might result in degenerative damage to the articular cartilage, which is permanent damage. This must be avoided. 
 
THAT’S why I recommended that he proceed with surgery. And now, you can understand the thought processes that led me to that conclusion, too.
 
In the end, judgment has to be based on the anatomical and pathological facts. And that’s another good reason to get your doctor involved early in the course of your knee problem. Til next time, my friend, be well.
 
Yours for a pain-free tomorrow and 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

January 19, 2010

Last week, while I was perusing my emails for Dr. Bill’s Clinic, I came across a request from one of my older subscribers. By older, I mean (quite naturally) older than ME. Ever notice how when anyone talk about “old guys,” they always mean older than THEM. Right?
 
Anyway, this man is, shall we say, in late middle age, has stayed in good shape and has been a runner for years. Problem is that he recently had a sudden onset of severe knee pain, after running to catch a bus, or something.
 
He was seen by an orthopaedist, who after examining him, decided that he may well have a torn meniscus. 
 
As you may know, there are two crescent shaped fibrocartilages, called menisci, which lie between the end of the femur (thigh bone) and the upper tibia (shin bone), inside the knee. 
 
They act as cushions and guides for motion of the joint, especially in twisting, or cutting movements. For more about these and other causes of painful knee pathology, please refer to my LITTLE GREEN BOOK:  http://www.drbillsclinic.com/eliminate_knee_pain.html
 
Because these cartilage structures are invisible on standard x-rays, the doctor ordered an MRI scan of the offending knee. This scan is terrific, because it can show the structures and can predict if they are torn, with an accuracy of about 90-95%, on the medial (inside) compartment of the knee.
 
Sure enough, he had a torn medial meniscus. But he also had a surprise–he had almost completely bare bone exposed on the end of his femur, in the medial compartment. The guy was understandably shocked. How could he have such bad arthritis and not have felt it before this injury?
 
The answer is, this is not an uncommon picture. Sometimes, the articular cartilage becomes degenerative and gradually erodes away, exposing the bone. Though most people will feel this as significant pain, as it happens, a few will compensate (high pain threshhold, endorphins, etc.) and will feel nothing, at all. Until something happens, as did here, to DE-compensate his defenses against pain. THEN, he felt it.
 
Naturally, as a believer in natural healing, he was leery of knee surgery. And studies have demonstrated that arthroscopic surgery added nothing to just medicine, physical therapy and exercises, like those I teach in my newly updated and expanded PAIN-FREE PROGRAM & DVD:  http://www.drbillsclinic.com/exercise_eliminate.html 
 
HOWEVER…in this case, I DID recommend that he go ahead with surgery. Here’s why.
 
This man is very active and wants to remain so. He has exposed bare bone and therefore, will need at least a partial knee replacement, perhaps a total knee replacement, when his symptoms warrant it. But then, he will NOT be able to run or do any exercises involving impact, which could damage, or loosen the artificial implants.
 
He also has a significant tear, easily fixed, in addition to his arthritis. It seems reasonable to conclude that if the tear were “fixed,” he might well “buy time” and return to his asymptomatic state, at least for a while.
 
The studies that recommended against knee surgery for arthritis were talking about a general “clean out,” or debridement, NOT addressing a specific torn meniscus, with very specific mechanical symptoms, directly attributed to that damaged structure. When dealing with arthritis and knee pain, it IS best to be conservative, in most cases, where there is diffuse disease and no specific mechanical symptoms, as seen here.
 
That’s why I wrote my newest healing program, HOW TO AVOID KNEE SURGERY, which you can get here: http://www.drbillsclinic.com/avoid_knee_surgery.html 
 
The many treatments from both conventional and alternative medicine are designed to help you avoid the UNNECESSARY procedure. but if the surgery IS necssary, as it was here, then it should be done.
 
Well, he DID have the arthroscopy, he did, in fact have the tear that the MRI predicted, and he DID do very well. He’s now glad he did it, as he has returned to his preoperative state of virtually no pain. And the procedure has bought him time, which he can continue to enjoy, until further progress of his disease makes a total knee unavoidable.
 
I love being right. 
 
And the only other recommendation I gave him that I would give you, too, is to get on my Powerhouse Omega Formula, an ultra pure, highly concentrated, pharmaceutical grade fish oil, with a special enteric coating that prevents any fishy aftertaste and the dreaded “fish burps.”
 
http://www.favoriteformulas.com  
 
Omega 3′s have potent, long term anti-inflammatory properties that help to control the pain of arthritis, a as well as many heart and brain healthy effects, as well.
 
I also advised him to consider giving up the running, in favor of power walking, or hill sprints, which avoid the damaging shocks to the weight bearing joints, seen with running. If he listens to me, these measures may buy him even more time….
 
Til next time, my friend, 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

January 15, 2010

Earlier this month just after the New Year, when I was still in the early stages of recovery from my hernia repair surgery, I had mentioned that there were going to be some changes coming down the pike, with Dr. Bill’s Clinic. One of them will be coming up just next month. I’ll be switching this daily email and the daily blog that it becomes, to another server.
 
This will mean a bit of chaos at first. But I can’t tell you how many people have told me that they’ve signed up, multiple times, to get my emails, but never received one. That includes my webmaster.
 
Now you may like my commentary, stories and health tips and find them valuable. Or you may find they’re not your cup of tea and move on. And that’s fine. I realize I can’t be all things to all people. And I realize that not everyone is going to agree with me. 
 
(Of couse, I tend to think of these latter people as narrow, ignorant, misguided, jealous bastards, while those who agree with me are highly intelligent, morally superior and perceptive, discriminating individuals, who are excellent specimens of the species, but I suppose that’s only natural.) 
 
But if you DO want to keep receiving these daily messages from me, you will have to take action, when it’s called for and OPT-IN AGAIN. Now, I know it’s a nuissance. And I know I’m going to lose some of my flock. Everyone who does this, does. But, whether you like my emails or you don’t, the fact remains that I work my butt off to knock them out, day after day. And I work too hard at it to accept that my efforts are, in large part, being wasted.
 
It’s far more likely that the “mail will get through” with this move and that you will receive your daily dose of Dr. Bill, without interruption. But, as I said, this will require some effort on your part, when the time comes.
 
Since you are here, that already tells me that you’re different from the herd. And so, instead of simply accepting that I will lose a number of my friends, through inaction or lack of information, I decided to give you a heads-up early, BEFORE the transition, so you will be expecting it and take the appropriate action, ie., sign up again and confirm that you WANT to continue to receive communications from me.
 
I will periodically make a number of repeat announcements over the next few weeks, which I hope will minimize the predicted loss of subscribers. It has to be done, though. And I hope you will want to make the transition with me.
 
But anyway, you have been warned.
 
The other big change is that, very soon, I will be posting PODCASTS on various medical topics on iTunes. The show will be called “The Wellness Warrior” and will feature episodes on health related topics that will help you be healthier, happier and live longer.
 
Some episodes will be 20 to 30 minutes long, mainly audio. Some will be short video tips, maybe a minute or two. But I hope that all of them will be interesting to you. Oh, and you can leave comments and ask questions and stuff, too. So, I hope you’ll sign up for them when they’re up and ready to go. I’ll keep you posted.
 
My first podcast will be an episode about Fish Oil–The Omega-3 Solution. I’ve already recorded it. I’m just fine tuning it, before it goes live. In this podcast, I’ll go over the many health benefits of pharmaceutical grade fish oil, especially my POWERHOUSE OMEGA FORMULA  http://www.favoriteformulas.com 
 
This will be an overview, explaining exactly what omega-3′s are, why you need them and how you can benefit from taking them. The following podcasts will continue in that vein, boiling down all the latest information to the essentials that you can use.
 
Later episodes will focus on the ways you can relieve your pain in simple, non-operative ways, that I cover in more depth in my healing program,  HOW TO AVOID KNEE SURGERY   http://www.drbillsclinic.com/avoid_knee_surgery   and still others will feature interviews with other physicians, surgeons and health care practitioners, to give you a well-rounded variety of opinions on a given topic. For example, I may interview a cardiologist on coronary artery disease and the things you can do to prevent clinical heart disease, or a rheumatologist, about how to cope with arthritis.
 
So, I hope you’ll stay tuned to the changes coming in Dr. Bill’s Clinic in the very near future. 
 
And if you have any particular topics you’d like me to address, or ideas about how I can make this more beneficial for you, please drop me an email. 
 
Meanwhile, thanks for all your support and for the kind remarks and comments that I often get from enthusiastic subscribers. I hope you’ll continue to want to be a part of my little health “family” and will take the necessary action, when the time comes.
 
Have a great weekend, my friend and be well. I’ll talk to you again soon. Til next time,

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

January 13, 2010

Just last night, as I was listening to the news, it was reported that a massive earthquake hit the island nation of Haiti, with a magnitude of 7.0 on the Richter Scale. This is the largest, most devastating quake in over 200 years and promises to be a major disaster for the Haitian people. Its epicenter was near the capital of Port-Au-Prince and reportedly, every other building was knocked down.
 
Though the weather services are watching closely for potential tsunamis, the real danger remains the series of powerful aftershocks. One such hit last night, causing a number of buildings to collapse. The chaos is near total, with no food, services, medicine, or medical care.
 
By the time you read this, the relief effort will be in full swing, spearheaded, no doubt, by the good ol’ USA. We have our faults, especially lately, but there has never been, in the history of the world, as decent and benevolent a hegemonic power as the United States. And, as Martha would say, “that’s a good thing.”
 
Even under the best of circumstances, Haiti is an exceptionally poor country, one of the poorest backwaters in the world, certainly the poorest in the Western Hemisphere. Ironic, because the other country that shares the same island of Hispanola, the Dominican Republic is a garden spot of the Caribbean. Perhaps it has something to do with their respective governments, or in the case of Haiti, its conspicuous absence.
 
The poor people there have rarely been cut a break. They always have some a$$hole trying to run them down, everyone from drug lords to Papadoc, to the last guy our State Department was trying to prop up.
 
I’ve been there a few times, usually as a day trip during a Caribbean cruise, often to the beach at Labadie, and I’ve always been impressed with the grinding poverty. It’s been reported that the average person there lives on two bucks a day–unbelievable! So, the last thing these folks needed was a disastrous earthquake.
 
My brother-in-law, John, is a master diver, or was when he was in shape. He had been hired, along with another friend, Pete, to search for buried treasure off the coast of Haiti. No, really. Salvage companies have the records of ships lost off the coast of the island and often organize diving expeditions, to search for lost vessels and their valuable cargos, based on their manifests. He told me that, between the drug problem and the Voodoo, he never wanted to return there. 
 
The bottom line is, the place is dirt poor and this catastrophe will only make it worse. The toll in human lives and miserie is only beginning to be counted. Let’s hope for the best for the people of Haiti in this trying time.
 
I’ve never been in an earthquake, myself. But I have freinds who have. And they tell me that it has to be one of the most frightening and disorienting sensations you can imagine. With the very ground unreliable, shifting beneath you, rockin’ ‘n’ rollin’ it has got to be one scary situation.
 
If it’s anything like being at sea in a major storm, though, which I HAVE experienced, I should think that having strong legs and stable knees might make the difference between safety and falling, with broken hips, or worse. 
 
The best way I know of, to ensure that your knees are up to any challenge, is to develop the muscles and tendons around them, by using the strategic, knee pain exercises that I teach in my new, greatly expanded PAIN-FREE PROGRAM and DVD
 
  http://www.drbillsclinic.com/exercise_eliminate.html 
 
By strengthening those muscles, you not only relieve knee pain, and prevent it, but you make your knees as stable as they can possibly be. It’s not only good for you, it’s cheap insurance of stability, when the world around you is going to Hell.
 
Meanwhile, our thoughts and prayers will be for the People of Haiti. Let’s hope the relief effort and an end to the aftershocks will minimize the human casualties and misery.
 
On another note, today is just shy of two weeks since my surgery for a hernia repair. I’m doing much better, and improving daily. I got the OK to start walking for exercise, as tolerated, but no lifting, or serious abdominal exercises for 6-8 weeks. Well that makes sense. The protein collagen (ie., scar or fibrous tissue, of which we’re all made, and which is the substance of the hernia repair, takes about 6-8 weeks to fully heal, and then another 6-12 months to mature, so…).
 
The surgeon gave me the OK to restart my pharmaceutical grade fish oil, so I have. But I have to start slowly, just as though I were starting out, which I am, after a fashion. Too much, too soon and I’ll get diarrhea, which would really stress my new repair and probably not be too comfortable, either.
 
My POWERHOUSE OMEGA FORMULA is an ultra pure, but very concentrated fish oil. I need to take one capsule a day, for a few days, then one, twice a day. As I reacclimate to the dose, I can increase in a week or so to two caps in the AM, one in the PM. And after another week, finally back to my maintenance dose of two caps, twice a day.
 
http://www.favoriteformulas.com 
 
By that time, its full anti-inflammatory effects should be in full swing, with relief of my chronic back and knee pain. Makes a real difference, I can tell you. You don’t really appreciate what it does, until you have to do without. Believe me, I know.
 
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

January 12, 2010

One of the most frequent questions I get is whether or not surgery is indicated for knee pain. Usually this applies to chronic, aching, long term knee pain, typically seen with osteoarthritis. But once in a while, it applies to a sudden onset, or an acute exacerbation of low grade, pre-existing knee pain.
 
Especially among those who lean toward the natural, often holistic treatments available in the realm of Alternative Medicine, the very idea of knee surgery is anathema. Even when they’ve been seen by a qualified orthopaedist, or other licensed health care practitioner, and been told that they do need surgery, suspicion remains.
 
Part of this is due to the Medical Profession itself, those practitioners who are overly aggressive in their promotion of the surgical approach. But part of it is unwarranted, based on a knee-jerk (sorry) assumption that a surgeon will always want to operate. That’s simply not true. 
 
The best surgeons DON’T operate on anyone who comes in the door. They only offer surgery when it’s appropriate, as the only, or the best alternative treatment, from the available options. I don’t even ask you to rely on the altruism of the surgeon. No. You can always depend on self-interest.
 
Just think about it. Were that NOT the case, if surgery was done frequently, without just cause, there would be a very high number of complications from unindicated procedures, poor results, very dissatisfied patients, and very, very unhappy referring physicians (because that would reflect badly on THEM). 
 
Result? The referrals would simply dry up and the surgeon would have no practice, in very short order. 
 
Surgeons survive and prosper by referrals from primary care physicians and other (HAPPY) patients. And the best way to enjoy an excellent reputation is to do the right thing, for the right patient, at the right time, consistently. That means to do surgery ONLY when it’s necessary and avoid unnecessary procedures.
 
Ironically enough, this approach is not only more honest and more in the interests of all concerned, patient, surgeon and referring doctor, but it results in the surgeon doing MORE surgery, that’s really needed.
 
Still, there is that suspicion, that little voice of doubt….
 
Let me give you a current example. One of my subscribers sent me the following email to ask for my opinion.
 
“Dear Dr. Bill,
 
I have arthroscopic surgery scheduled for tomorrow for a “potential” meniscus tear in my left knee (interior). I just stumbled onto your website and am having second thoughts about having surgery. I am 39 and in good health. 
 
The pain in my knee started after overindulging in three days of soccer, running and biking. It started about four months ago. It initially swelled and was painful to walk on, but is now just occasionally sore (mainly before storm events and after heavy use). 
 
My knee is tender on the inside, lower area. I have full range of motion and do not want to risk losing this due to surgery complications. Your insight would be greatly appreciated.”
 
I advised him to proceed with the surgery, which was arthroscopic, after all, and likely to cause little disability. He just sent me copies of his intraoperative photographs, taken by his surgeon as documentation of pathology, a standard practice today. He did indeed have a degenerative tear of his posterior horn of the medial meniscus. And the surfaces of his knee were otherwise in good shape. All this was consistent with his symptoms and his diagnosis of a torn medial meniscus.
 
That means that if surgery were NOT done, he would certainly have developed irreparable cartilage changes and ultimately, arthritis. In other words, this was a NECESSARY surgery. However, the same tear in someone who already had severe arthritis may, or may NOT be necessary, depending on his symptoms.
 
So, in this instance I was right. His surgeon was right. And, ultimately, the patient himself chose correctly.
 
So what can you do to choose correctly for your own knee pain? First, and I’ve said this over and over, get a real evaluation by an orthopaedist, or at the very least, a licensed health care practitioner. 
 
It’s what you DON’T know that can hurt you. No one can make you have surgery. But you need information to make a rational decision. And this is the best way to get complete information, so you can explore your options, based on what your problem actually IS.
 
By all means TRY conservative, non-operative measures, from the entire spectrum of treatments, alternative as well as conventional, like those I teach in my newest healing program, HOW TO AVOID KNEE SURGERY
 
  http://www.drbillsclinic.com/avoid_knee_surgery.html 
 
For example, inflammation is usually part of the reason for pain. Reducing inflammation will almost certainly reduce pain. One natural way to do that is to take a pharmaceutical grade fish oil, like my ultra pure, enteric coated, POWERHOUSE OMEGA FORMULA    http://www.favoriteformulas.com 
 
Local heat and strategic exercise also play a role, as do braces and ambulatory aids, at times. In many cases, pain can be resolved and function restored, using these nonsurgical therapies. 
 
But at other times, an operation IS the conservative thing to do. So don’t suffer needlessly, wondering should I, or shouldn’t I?
 
It’s a matter of judgment, based on the facts. So get your doctor involved early. And though you SHOULD be sure you are kept informed and fully understand ALL your options, don’t automatically assume that the doctor is there to screw you, or give you a surgery you didn’t really need. Most of us are pretty decent guys, if you give us a fair chance.
 
Til next time, my friend, 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

January 11, 2010

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