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

If you’ve been a reader for a while, you know that I’m a long time comic book collector. I used to work as a professional artist for the comics, back in the 70′s for a brief stint and I’ve always maintained a serious interest in the art form, collected original art and kept up friendships with some of the best pros in the business.
 
This, of course, has always been a source of great embarrassment to my wife, who shares the opinion of many, who know no better, that comics are for kids, geeks and retards. I would patiently point out that there is an entire wing in the Louvre dedicated to graphic arts (ie., comic art)and many very highly creative, very wealthy and intelligent men, like George Lucas, Steven Spielberg and Clint Eastwood, to name but a few, have collected original paintings and drawings of some of the best modern illustrators, painters and comics artists. So I feel I’m in good company.
 
Anyway, as soon as I arrived back in town, in Orlando, I went straight over to my local comic shop, ACME SUPERSTORE in Longwood, to pick up the latest issues which had come out during my recent absence. While I was in there, seeing what else had come out that I might want to read, I overheard a middle aged guy talking to Penny, one of the store employees.
 
Penny had had arthroscopic surgery for her own knee in the past, after a number of conservative measures failed to relieve her very significant and disabling knee pain. I had reviewed her preop studies and her intraoperative photographs, and there’s no question she had a defined pathology that needed surgery to fix.
 
This guy knew about her experience and was asking her for advice. So, since she had come to me for advice herself and since I was there, she called me over to meet this man. Sure enough, he had episodes of pain and swelling that would come and go, after what he called a “blowout,” that is, a traumatic injury that ruptured his ACL (Anterior Cruciate Ligament) and gave him a torn meniscus.
 
Despite this, though, what bothered him the most was what he described as a sudden “shift” inside his knee and the insecure feeling this gave him. What he was actually feeling was the typical instability that results from a ruptured ACL. Naturally, he was concerned because he didn’t want ACL surgery, if he could avoid it.
 
I pointed out to him that there ARE ways to treat this condition nonsurgically, BUT there is a price to be paid–namely, if he doesn’t have arthritis yet, he soon will. The articular cartilage is damaged every time he experiences that “shift,” which is really a slippage of one bone on the other, that is usually prevented by an intact ACL.
 
However, if he is willing to accept that fact, and if his daily activities are not affected, then a number of conservative conventional treatments, combined with alternative methods, that help to relieve knee pain and resolve inflammation, appropriate bracing and vigorous specialized exercises, especially for the hamstring muscles, may be all he needs. 
 
He was amazed at this information, which was all new to him, and which is revealed in detail in my new healing program, HOW TO AVOID KNEE SURGERY (see here at http://drbillsclinic.com/avoid_knee_surgery.html )
 
He didn’t even realize that CRUCIATE means “crossed” in Latin, or that the cruciate or crossed ligaments, ACL and PCL, hold the interior of the knee together and prevent excessive, abnormal motions, front to back and back to front, between the femur and the tibia.
 
The anatomy and basic functions of these ligaments are presented in my LITTLE GREEN BOOK, together with lots of inside information on the many root causes of knee pain and disability. See what I mean at   http://drbillsclinic.com/eliminate_knee_pain.html
 
So, at the end of my “comic shop consult,” this man realized that he has options he didn’t know he had. I gave him my card and suggested he visit my website  http://drbillsclinic.com/avoid_knee_surgery.html  for more detailed information and advice. Hopefully, he’ll take my advice and get knee pain relief and joint stability back in his life.
 
At that point, I said, “My work here is done!”  Then I grabbed my comics and leaped out into the night…up, up and away……Heh.
 
Have a great weekend, my friend. I’ll be spending mine shooting the DVD version of my PAIN-FREE PROGRAM
 http://drbillsclinic.com/exercise_eliminate.html   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

So here I am, sitting in the study of the Southern Command Post, reviewing emails. And I came across one from a nice lady who is very concerned because she has knee pain, she is very heavy, given her size and worst of all, she has noises inside her joints that can actually be heard by people around her.
 
She was quite properly concerned because she’d like to get rid of her knee pain, and she wanted to get a copy of my newest healing program, HOW TO AVOID KNEE SURGERY (which you can get here at this link:  http://drbillsclinic.com/avoid_knee_surgery.html ), but she was afraid that it was already far too late for her–that the noise in her knees meant that all the cartilage had worn away completely, and that she had a “bone-on-bone” condition. This is what we in the trade call an “end stage knee.”
 
When articular cartilage, that normally coats the joint surfaces, is so diseased that it has eroded away and exposed the underlying bone, the naked bony surfaces grind upon each other with a deep, hard grinding sound and sensation that, once experienced or heard, is difficult to mistake for anything else.
 
It really is like rubbing two big rocks together, with grinding, rubbing and at times a mechanical ratcheting sensation. And, since the bone is where all the nerves reside, it hurts like hell! And that doesn’t count the extra pain from the inflamed lining membrane (synovium) that adds its own component to the pain.
 
So whether it’s osteoarthritis or rheumatoid arthritis, it’s at this end stage of disease, with exposed, bare bone, when major surgery IS truly indicated. Because at this state of the art, at this time, we cannot yet regrow new, healthy articular cartilage in a totally arthritic joint. The best we can offer is total knee replacements. And when they are indicated, they can be wonderful: pain relief, restoration of function and correction of deformity, with good to excellent results in over 95% of cases.
 
BUT…it’s major league surgery, with lots of risks and potential complications. So you don’t do it if you don’t HAVE to. 
 
However, all noise from within the joint doesn’t necessarily mean that your joints are finished and you need major surgery. Other conditions can cause noise, as well. When the lining of the joint becomes inflamed and swollen, its folds become thickened and enlarged. They rub upon each other, making a finer, more delicate crunching that we call crepitus or crepitation. 
 
If the membrane is restored to normal, the inflammation resolved, the swollen folds stop rubbing together and the noise stops. But if the condition persists for a long time, the membranous folds may become replaced with fibrous tissue (they become bands of scar tissue) and they then must be cut away surgically, to eliminate the sensation and the sound.
 
Then, there is degeneration of the articular cartilage surfaces, which may break apart into shredded beds of cartilage fronds, appearing like areas of “crab meat.” When these fragmented or fibrillated regions rub, one upon another, they too produce a crunching sensation, like walking in a gravel pit. 
 
This condition is called chondromalacia (“soft cartilage” grade III) and once this point has been reached, where there is physical disruption of the cartilage surface, it can never again return to a pristine, smooth surface. I discuss this disease and the various types of arthritis in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN (manual and CD). Get it here at: http://drbillsclinic.com/eliminate_knee_pain.html  However, even though the knee is noisy, it doesn’t mean that it will immediately go on to full end stage arthritis. The knee can stabilize in this state for a long time, sometimes pain-free (if a little noisy), if treated with the exercises I teach in my PAIN-FREE PROGRAM. See what I mean at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
The point is, this lady has nothing to lose and everything to gain by at least trying all the conservative measures that are available, to relieve knee pain. One of them, or some combination of them, may give her the knee pain relief she seeks, and buy time, until she can lose weight and make an eventual surgery safer and more likely successful. 
 
So the next time someone, maybe you, says, “Hey, what’s that horrible crunching noise in my knee?” now you know what some of the reasons might be. And some may well be treatable by non-surgical measures, like those in HOW TO AVOID KNEE SURGERY: http://drbillsclinic.com/avoid_knee_surgery.html   Noise doesn’t necessarily mean it’s the end of the line, or that a total knee is the only option.
 
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

Back in the Dark Ages of 1969, I started Medical School like many generations of young doctors-to-be before me, with Gross Anatomy. I understand that the powers that be have demoted the importance of Anatomy in the training of medical students, teaching only that fragment of the whole necessary to have a basic understanding of whatever topic is being discussed at that time. 
 
Like much in education today, all change is not progress…but I digress. 
 
At that time, having a sense of the whole mechanism of the human body was still considered a necessary fundamental. So Anatomy was where everything began for us.

Now, in all the Pre-Med training in High School and in College, Anatomy was always a staple subject, as a part of Biology, together with Chemistry, both Inorganic and Organic, and Mathematics (though why they thought you needed higher Math to be a physician was and is beyond my comprehension–especially Calculus). 
 
But the Anatomy studied was always that of the lower orders: frogs and earthworms in High School, dogfish (tiny sharks) in Introductory college Biology, and progression up the taxonomic scale with each succeeding course through The Fetal Pig and finally, The Cat in Mammalian Anatomy. And with each textbook, filled with anatomical minutia we were expected to memorize, there was an actual animal, preserved in formaldehyde, we were expected to dissect.
 
Sure, there were discussions and pictures and textbooks color slides and even movies (pre-video–these were 16mm films. I TOLD you these were the Dark Ages:) of human anatomy, boiled down to its essentials. But mainly, the study of animals was used to acquaint the student with the various physiological systems, which were then related to human beings.
 
But in Medical School, this was finally the real thing: the gross dissection of the human body. The cadavers were bodies from a variety of sources, from homeless people, who had died on the street, to physicians and scientists, who had willed their bodies to Medical Science, for the education of the next generation of physicians. Regardless, each was a precious gift, a key to unlocking the secrets of the human body, as a foundation to understanding its workings. And we all honored their gift and treated their remains with the utmost respect.
 
Each cadaver was preserved in formadehyde and the pungent odor permeated every square inch of the huge and brightly lit room of the lab, with dozens of stainless steel tables, each holding a body draped entirely in a long white sheet. 
 
As we trudged into the Anatomy Lab that first day, we all had on our new long white lab coats and carried our dissection manuals. We were assigned in groups to a table and a cadaver, which we would be expected to dissect, as instructed.
 
Naturally, we were nervous–anticipation was high, but for most of us, this was the first time we had seen a dead body, up close and personal. But, this was our introduction to the mysteries of the human body that we were all determined to master, our first step into the unknown, but knowable.
 
Each group had to choose two dissectors, that is, those students who would actually do the cutting, while the others watched. I naturally volunteered. I figured since I wanted to be a surgeon, I might as well get started. So, my partner and I carefully peeled back the layers, one section at a time, according to the guide and our instructors, exposing the secrets beneath. 
 
It’s harder than you think–cadavers are stiff and leather-like, and the parts are NOT color-coded like they are in the books. Everything is of a similar pale bleached tan, so unlike the color and texture of living tissues. And you have plenty of time to think about the nature of life. 
 
This inanimate body was once a living, breathing person, had a mother and a father, perhaps a family, had hopes and dreams, joys and sorrows, even as we. And yet, now, he lay here, inert, like a meat machine that someone turned off. Even as, one day, we too will lie somewhere, just like this. Can this be all that there is to us? Makes you think….
 
These anatomical fundamentals provide the necessary foundation for the understanding that emerges when you eventually experience the dissection of living flesh. It was an extraordinary experience.
 
Those students who drew back and were mostly grossed out by the whole thing, well, you just knew they were going to be the internists of the group. Some spent most of the time in the library, learning from books, instead of the cadaver. But I always learned better when I could SEE and FEEL and TOUCH, in three dimensions, with my own hands. To experience is to KNOW. 
 
For example, the first time I dissected the human knee, I SAW the fibers of the vastus medialis obliquus (VMO) muscle, inserting into the upper, inner margin of the patella, while I noticed that the other three muscles of the quadriceps were all attached to the tendon ABOVE the kneecap. So, based on this arrangement of the muscles, the VMO pulled inward on the kneecap, while the other muscles pulled outward.
 
It was only years later that I came to understand the physiological consequences of that anatomical fact, and its clinical significance. In fact, that’s the very reason that the exercises taught in my PAIN-FREE PROGAM, which you can see for yourself here at http://drbillsclinic.com/exercise_eliminate.html  concentrate so strongly on developing the VMO, in order to balance the kneecap and relieve anterior knee pain.
 
It’s also the reason that you can often relieve your knee pain if you do modified Hindu Squats, or even Straight Leg Raising. These exercises take advantage of that anatomical arrangement to relieve your pain. See how at http://drbillsclinic.com/exercie_eliminate.html
 
But this was the beginning. Years later, when I was being taught the arts of surgery, there were many times that I reflected on the lessons learned in Gross Anatomy Lab, and thought with gratitude upon that unnamed person who had granted me the gift of his body, that I might become a healer of my fellow man.  “Greater love hath no man…”
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

 I’m back in Southampton, having flown in yesterday. So this past morning, we drove to the airport to pick up my father-in-law and his wife. We thought it might be nice to gather at the new house for Thanksgiving and to see in the new Christmas Season. 
 
And to be honest, there’s something bizarre about having Thanksgiving and the Christmas Holidays in 70-80 degree temperatures in Florida, when you’ve grown up associating them with the cooler weather of Fall in the Temperate Zone. You know, the whole “chestnuts roasting on an open fire” thing rings truer when “Jack Frost is nipping at your nose.” When it’s perrenial summer, not so much.

So, to prepare for the Season, my wife got us tickets to Winter Wonderland in New York for later this afternoon. True, the Rockerfeller Center Christmas Tree won’t be lit yet; the official Christmas Tree Lighting Ceremony won’t be for a couple of weeks– I think it’s December 4th. But all the other Lights and Christmas Decorations will be up and well worth seeing. 
 
So, I was prepared for cooler weather and looking forward to it. But last night, my wife and I went out shopping, and man, it was COLD! Late last night, it was down into the twenties. I guess I’ve been in Florida too long. I was looking forward to the cooler weather but here I am, freezing in Southampton!
 
Well, hopefully, it will warm up a little later. Brrrrrrrrrrr! This part of New York I didn’t miss.
 
Funny thing about cold weather is that, like damp weather, it can make your joints ache when you have any degenerative joint disease. Among the things that can make you feel better and provide a little relief are supplements and joint wraps.
 
I’ve mentioned before that if you improve the balance of Omega 3 Fatty Acids in your diet, by avoiding red meat, saturated fats and other sources of Omega 6 Fatty Acids and then taking fish oil and other sources of Omega 3′s, you can reduce inflammation and therefore, relieve joint pain.
 
You can also keep your joints warm, too. Ways to do this range from simple elastic or neoprene knee sleeves, to far infrared capturing KENKO wraps and magnetic knee wraps that generate  internal heat within the joint tissues (both are available from your nearest NIKKEN distributor). 

These and a number of other methods for relieving knee pain are described in greater detail in my newest healing program, HOW TO AVOID KNEE SURGERY. See it at http://drbillsclinic.com/avoid_knee_surgery.html 
 
In addition, I list a number of other methods, from across the entire health care spectrum, to relieve knee pain and restore knee function–conventional, alternative and complimentary. And I include a Baker’s dozen of the most effective exercises to prevent and eliminate knee pain, for long term relief. See them at   http://drbillsclinic.com/avoid_knee_surgery.html
 
Gotta go! Til next time, my friend, be well. And stay warm….
 
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

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

Well, as you may or may not recall, Jonathan Swift was a satirist, responsible for some pretty biting criticisms of his society at that time (my favorite was “A Modest Proposal,” which suggested that a way to deal with famine was cannibalism). And Gulliver met people both much smaller (Lilliputians) and much larger (Brobdingnagians) than himself. But I think my subconscious took the image more literally, perhaps portraying various problems and concerns I might be thinking about as those pesky lines, binding my “big self.” And in taking this form, the dream itself suggested the solutions. 
 
What’s interesting about this metaphor is that in order to break free of those entangling lines, ACTION is required. Passive acceptance of his situation will only result in further loss of freedom. It’s only Gulliver’s travails that will ultimately set him free.
 
In the same way, if you have any problem, physical, mental or spiritual, the worst thing you can do is nothing. Passive acceptance guarantees no change. You have to analyze your situation, determine what’s necssary to change it, and then you must take the necessary action to effect that change.
 
For example, if you’re crippled with arthritis, or suffering from knee pain of any cause, just sitting around won’t change your condition. You have to TAKE ACTION, like the simple, non-surgical treatments and the specialized modified exercises I teach in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at this link:  http://drbillsclinic.com/avoid_knee_surgery.html
 
If you want to relieve your knee pain, FAST, and restore your joint stability and full function, then you need this program! Click on the link and see how:  http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

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

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

My wife, who was mortified at my extracurricular interest, as being somehow beneath my station, would often exclaim, “A man in your position! What if your patients knew what you read in your spare time?!” 
 
With characteristic modesty, I would always reply, ”Honey, when you’re as smart as I am, you really don’t give a damn WHAT they, or anyone else, thinks!” C’mon! It’s not as if I was doing anything that was illegal or immoral (I keep those activities strictly hidden
 
Anyway, it was an off day, Friday, when I finally made it there. The owners and most of the staff were away, and only Penny, one of their sales associates (a very pretty blond and, as it happens, one of my listed testimonials on the website) was there. She got my comics from my file, and, sure enough, there were some other books I wanted, as well.
 
As I took the books to the register, to pay for them, I noticed that Penny didn’t look too happy–not like her, at all. “What’s the matter?” I asked. “Oh, my knee’s been bothering me lately. It’s feeling kind of numb,” she replied. 
 
From many long years of clinical experience, I knew to ask her what she meant by “numb.” See, my father-in-law would always say he felt “numbish,” by which HE meant a dull aching pain. To me and any other physician, “numb” means something entirely different: a decrease in sensation, usually soft touch. But had I not learned that some folks SAY that, when they really mean a deep, dull pain, we could’ve been there all day, not understanding each other.
 
Then, she said that the pain was behind her kneecap, but indicated with her hand that it was really behind the entire knee, in back of the leg. Again, a potential failure to communicate, had I not seen her point. 
 
But the kicker was that she also had pain in her buttock, right in the middle, just behind her “hip bone” (greater trochanter), above the “painful knee.” And it would radiate down the outer, posterior thigh into the knee and the upper calf. Well. Even though Penny had previously had arthroscopic knee surgery, to treat real pathology (I saw her intraoperative photographs), her problem was really one of sciatica– pinching or pressure on the sciatic nerve, probably as it emerged from the sciatic notch in the pelvis, on its way down the lower extremity.
 
Sometimes, “knee pain” isn’t from the knee at all. Other problems, in the spine, the hip joint, the pelvis, the sacroiliac joint, the abductor muscles, the trochanteric bursa, the piriformis muscle (which I suspect in Penny’s case) can give a false impression of knee pathology, even though the true cause is from a distant site. You can learn more about all the root causes of knee pain in my LITTLE GREEN BOOK; see it at  http://drbillsclinic.com/eliminate_knee_pain.html
 
By this time, we had a few of the other customers watching us, as I conducted a cursory exam and ran my makeshift “comic shop clinic.” I gave her some advice, like the alternative measures I reveal in my new healing program, HOW TO AVOID KNEE SURGERY at   http://drbillsclinic.com/avoid_knee_surgery.html   My tips included ways to rapidly reduce any local inflammation, relieve pain and stretch the offending tendon, which is placing the sciatic nerve under pressure. If she does what I told her to do, she’s  likely to be better in just a few days, without even a doctor’s visit (unless you count mine .
 
If you, or someone you know has knee pain, there are a number of effective methods to relieve it, and do it without expensive drugs or surgery. See how at:  http://drbillsclinic.com/eliminate_knee_pain.html   And if you think you need knee surgery, first try: http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

 Did you ever get a phone call or email out of nowhere that was from an old friend that you’d lost contact with and you thought you’d never hear from again? If you have, then you know what I felt over this past weekend, just the other morning, when my phone rang me out of a sound sleep. 

Since my internship, I’ve had the facility to awaken instantly and answer the phone before the first ring finishes. Call it a conditioned response. It’s sort of drilled into you, when you’re in training, because nurses have a way of calling you, just as you’re drifting off to slumber land, after an eight hour shift.
 
I subsequently learned how to anticipate this tendency (some would call it an exercise in sadism) and write orders that put my patients on autopilot. If orders were there, the nurses had their instructions and didn’t need to call me, unless there was a REAL, honest-to-God emergency. But the neural pathways that were burned into me by the training during those formative years have survived and remain with me to this day.
 
Anyway, they were on full display when the phone rang on Saturday morning. As usual I went from deep sleep to wide awake in seconds, grabbed the phone off its cradle and out of the blue, I heard the voice of my old buddy, Josh. This was really a voice from the past!
 
Josh is and was a great photographer. In fact, if you’ve ever seen those posters, sold in frame shops, of the architecture and sculpture of Grand Central Station, in New York City, done in black and white, those are Josh’s photos. We met years ago in Long Island, through my brother-in-law, John. Josh was one of those people who are so hyper, and so UP all the time, that they are really fun to be around. You just can’t be depressed or feel like lying around when he’s with you. He was funny and a really talented guy: his photos are far more than just “pictures;” they’re real art.
 
When I was writing my magnum opus, THE ART OF TOTAL HIP ARTHROPLASTY (originally published by Grune & Stratton, in 1987and now available through W. B. Saunders & Co.), Josh did many of the photos for the book, especially the antique hip implants. He shot them the way he would normally shoot jewelry, or some fashion piece, with a tent, and indirect lighting–the photos were fabulous; far superior to what normally passes for imagery in an academic text. 
 
Later on, we took Josh with us on a trip through Europe, a kind of side extension when I was presenting a lecture at the British Hip Course at the Orthopaedic Hospital in Oswestry, Wales. He brought his cameras with him, and as a result, we got some of the best “what I did on my summer vacation” photos imaginable.
 
We even went on a vacation to an exclusive resort in the Caribbean, Cap Juluca, on the Island of Anguila, with Josh and his new bride. Unfortunately, that particular liason didn’t work out–the parties were just too different. But the point is, he was very much a part of our lives, fun to be around and never boring.
 
Then, one day, he was just…gone. He apparently up and left behind his businesses and moved to North Carolina. Never said goodbye. Never wrote or called. Most odd. And of course, we missed him. At that time, though, I had my own problems, what with my back injury, winding down my practice and moving to Florida. I tried several times to track him down, but always met with frustration.
 
Finally, a couple of months ago, I was just thinking of him, having unearthed one of his masterpieces from my photo files. And I started a web search. I finally found him on a website he had posted and left a message. I encouraged him to call, but–nothing. So, I reluctantly concluded that, for whatever reason, that he didn’t really want to stay in touch. And respecting that, I let it go… 
 
Then, from out of nowhere, he called. And, ironically enough, turns out that he has a client in Winter Park, not 20 minutes South of us near Orlando, Florida. He now has a print business, where he produces high quality giclee art prints for artists and photographers, as well as his photography. And he had his reasons for just “disappearing.” Turns out that he had lost my cell phone number, we had moved from the house and that was the only number he had. 
 
Could he have found us? Probably, but everyone’s got their own priorities, right? I learned long ago that if you want someone’s friendship, you have to accept them the way they are. Try to change them, expect them to change, and you’re doomed to disappointment. The important thing is, we’re back in touch now, and that’s all that matters.
 
Naturally he wanted to know how we were doing, and what I’ve been up to. I told him about my struggle to pick up the pieces of a broken career, after my injury effectively removed my ability to do surgery, as an option. I told him about my efforts to help people with knee pain, through my web services and my publications, and I sent him to see my newest healing program, HOW TO AVOID KNEE SURGERY, at
 http://drbillsclinic.com/avoid_knee_surgery.html
 
Turns out he’s had some problems in that area, like many Boomers, so he’s looking for some slick non-surgical methods to relieve knee pain and restore his function to normal. No problem. He just needs to follow the instructions and advice I give in this new program, and his pain will be gone, for good–and without surgery, too. See what I mean at  http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

The newswires were all abuzz yesterday with a study out of this week’s New England Journal of Medicine. The study was done by a group of Canadian researchers, looking at the results of treatment of arthritis pain in two groups of patients in North America, from 1999 through 2007.  One group was treated by arthroscopic surgery. The other was treated with conventional, mainstream non-surgical methods, including anti-inflammatory medications and physical therapy.
 
The headline from this study was that there was NO DIFFERENCE between those that were treated surgically and those who were NOT. This, of course, suggests that surgery done strictly for arthritis pain is not warranted. The trouble with this news flash is that it’s really not news, or at least it’s yesterday’s news.
 
In 2002, another study was done, comparing arthroscopic surgery with sham surgery (ie., a skin incision was made over the knee, that was sutured,  but instruments were not introduced into the joint, nor were any intra-articular manipulations done).  This study found similar findings among U.S. Veterans in the Veterans Administration Hospital System. Again, the use of arthroscopic surgery for the treatment of arthritis pain was discredited. Short term relief of pain in BOTH groups (ie., real surgery and sham or fake surgery) was the SAME! This was attributed to a placebo effect.
 
This prior study was so impressive that Medicare used it as a basis for determination in refusing to pay for arthroscopy for the treatment of arthritis pain. And this study was a reinforcement of an even earlier study that compared arthroscopic surgery with merely lavage (injecting and extracting saline, or salt water, into and out of the knee joint, to wash it out). Here, too, there was NO DIFFERENCE between the surgery and the wash-out groups. So here is more evidence of what you know instinctively–letting the body heal itself is the best course, except in advanced, or end-stage arthritic disease.
 
In my years of practice, it was my experience that if a patient had full-blown arthritis, there was little reason to ‘scope them, UNLESS they had a sudden increase in very specific joint line pain, or giving way (so-called mechanical symptoms) that suggested a displaced or entrapped tear of the meniscus, or a rip-roaring synovitis (as in Rheumatoid Arthritis) that would not respond to medical treatment, or needed relief but were a poor risk for major joint surgery, like a total knee replacement.
 
This is why I consider this “old news.” I used arthroscopic surgery for very specific mechanical or synovial overgrowth problems, NOT just as a “catch-all” treatment for arthritis pain. I always advocated a conservative approach first, letting the knee itself declare if and when it was ready for a major surgery.
 
I STILL DO.
 
Like I’ve said before, there are times when surgery is absolutely needed. To deny this, or make frankly STUPID statements that “surgery is NEVER warranted,” is to deny the facts. But surgery should be the last or the best option–not the first line of defense. In short, you want to AVOID the UNNECESSARY SURGERY. 
 
And to help you do just that, I wrote my newest healing program, HOW TO AVOID KNEE SURGERY
 http://drbillsclinic.com/avoid_knee_surgery.html   With conventional and alternative methods from across the entire medical spectrum, you have everything at your fingertips to relieve your knee pain, but stay OUT of the Operating Room.
 
If you want the very latest methods to get rid of that nagging knee pain for good, but want to do it WITHOUT SURGERY, then you need my program. Order it here:  http://drbillsclinic.com/avoid_knee_surgery.html
 
Have a great weekend, my friend, and be well. Til next time…
 
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