When I first started my surgical practice, I was part of a group of talented surgeons. My pal and common assistant at that time was a great guy named Steve, who was a few years older than I. We had a natural affinity and were similar in temperment, so we tended, more and more, to work together.
 
Steve and I were associates, not partners. That means that we shared office space, and expenses, but not revenues. Although, like many surgeons just starting out, I was on salary at first (in my case for six months). 
 
Well, Steve was a natural diagnostician (those are born, not made) and a pretty damn good surgeon, in his own right. He was so good, that many years later, I asked him to do the surgery on my mother, when she needed to have her left hip replaced. We were thick as thieves and very attuned to each other’s rhythms in surgery. So we were a very good team indeed.
 
Thing about Steve was that he wouldn’t do surgery on just anyone. They had to prove to him that they had failed at all conservative treatments first and that their pain was unrelieved by any lesser treatment. In that way, he strongly influenced me and tempered my impatience to jump to the surgical approach, an understandable impulse in a young guy who has just spent his youth preparing to be a surgeon and believes in his ability to do anything.
 
One of the senior men in the group, Art, a brilliant hand surgeon, whose like I have never seen, before or since, took me aside one day and gave me some counter-intuitive advice I took to heart.
 
“Listen, Bill,” he told me. “I know you want to do a lot of surgery. But be patient. Don’t jump right at surgery, first thing. You’ll only scare them away.  Instead, try everything else first. Brace them, give them medicine, injections if they need them. Make them ASK you, or better yet, BEG you for surgery, before you do it.”
 
“Huh?” I said, brilliantly.
 
“It’s simple,” he said. “People and their referring doctors want a surgeon who isn’t “knife happy.” They want to know that you’re operating on them because you don’t have a choice, not just because you can.” 
 
“But, how can I build a surgical practice like that?” I asked. 

He smiled and told me a profound truth, that I remember to this day. “That’s the irony of conservative treatment,” he said. “If you try NOT to do surgery, you’ll end up doing even MORE than you can handle. 

“You see, people want to know they can trust you. They need to feel they can believe what you tell them. If you treat them conservatively and help them, when they REALLY need surgery and can’t avoid it, they’ll come back to YOU, because they trust you.”
 
I admit I was skeptical at first, but this guy was not only a brilliant surgeon, who I greatly admired, but a highly successful practioner, who had an enormous practice. So I decided he must know what he’s talking about. I resolved to follow his advice and see what happened.
 
Well, the rest, as they, say is history. I did what he advised and lo and behold, my practice burgeoned.  In fact, it perfectly tracked Art’s own successful practice, just trailing his profile by eight years. I was a believer.
 
And over time, I realized that it was not only smart business, but it was correct ethically and morally, as well. In fact, it’s just really good Medicine. 
 
Surgery should be the last or the best option, not the first choice of treatment, in most cases. The object is to let the body heal itself, if it can, and only intervene surgically when there is no other choice, or when that will yield the best result. 
 
In other words, avoid the unnecessary surgery. And do the best surgery possible, when that is the best option. 
 
This has been the guiding principle of my life for all these many years. And it remains so today, as demonstrated in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can get here, at  http://drbillsclinic.com/avoid_knee_surgery.html
 
With treatments drawn from across the medical spectrum, conventional, alternative and complementary, most knee pain will respond to some combination of these proven remedies. See for yourself and unleash your body’s own healing potential. Relieve your knee pain 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

So this morning in my study, I was going over a number of health related blogs, reviewing them for any potential for commentary and teaching points. A number were pretty good, most often involving the back injuries one sees in sports or exercises or stretches for general fitness or specific injuries. A few had to do with joint replacements of the hip and knee, which happened to be my specialty in practice. 
 
But then, I read one that was incredible. Not good incredible, as in ‘Wow! How amazing!” but incredible as in, “I can’t believe they have this thing out there on the web!” It concerned ACL injuries and rehabilitation and it was so full of factual errors and frank mythology that I couldn’t believe it.
 
I wanted to tactfully reply, correct the most obvious misconceptions, hopefully without insulting the author, or hurting his feelings. It wasn’t a scam, or a deliberate attempt to misrepresent facts for some nefarious purpose. It was obvious that the author was sincere. He was just wrong.
 
For example, one guy said that an ACL rupture wasn’t painful. In fact, it’s one of the most painful and disabling injuries you can suffer. What he meant was that a CHRONIC ACL disruption is painless–the damage has already been done. But the resulting instability, the “wobbly knee” that results from absence of the ACL, CAN indeed cause pain, from secondary tears of the menisci, synovitis, and arthritis.
 
Further, there ARE some people with an ACL injury who DON’T require surgery. This fact is almost entirely ignored in these articles. Specific exercises, especially leg curls and calf exercises, can often compensate for people who make low demands on their injuredknee. The point is, there are options that can be offered.
 
Unfortunately, it was a major pain to reply. First, you have to register in order to reply. Then, the registry doesn’t accept the information and erased all the info I had just input. Finally, I just gave up in disgust. Too bad. Some people are going to read that blog and accept what it says uncritically. As a result, they’ll absorb information that’s just incorrect. And who knows what the consequences will be?
 
Funny thing is, people will believe almost anything they read on the net, even though it’s well known that there’s no filter. That’s one of the internet’s chief charms. But it’s also one of its chief problems, when you really have a need to know the facts about a topic. Without a bit of comparative research on your own, there’s often no way to tell what’s fact and what’s fiction.
 
You may read it on a website, but “it ain’t necessarily so.” But the written word has power to persuade, whether it’s accurate or not. So, especially in seeking medical information, it’s best to go with a trusted source. Hey, that’s one of the major reasons for the existence of Dr. Bill’s Clinic. I’m here to try to provide some guidance and practical advice, based on my nearly quarter century in clinical practice in orthopaedic surgery. That’s why I wrote my healing programs: to help those of you with knee pain, grinding, instability, arthritis, water on the knee, deformities, and any other problems with a variety of treatments, conventional, alternative, and complimentary, from across the entire medical spectrum.
 
DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN is a concise, but complete guide to all the root causes of knee pain and the treatments that I know from experience, professional and personal, do work. You can get your own copy, including an audio CD, at  http://drbillsclinic.com/eliminate_knee_pain.html
 
But, just so you know, the LGB does NOT include the recommended knee exercises. Those are given in a separate companion manual: DR. BILL’S PAIN-FREE PROGRAM, a selection of exercises and stretches that helps to prevent or eliminate knee pain–once & for all! You can get it here, at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
Most recently, based on what people seemed to want, I created my newest healing program, HOW TO AVOID KNEE SURGERY, in both written and audio CD formats. This is a blend of the former two programs, and in addition, adds a great deal of new material, especially on herbs and nutriceuticals and other alternative treatments to help you avoid the unnecessary knee surgery, or at least delay the most invasive procedures, like total knee replacement, in the case of end stage disease, like arthritis. 
 
If you’ve been thinking about having surgery, but would like to delay or avoid it, you can get it here: http://drbillsclinic.com/avoid_knee_surgery.html
 
So, above all, don’t believe everything you read. DO your due dilligence before you accept whatever is out there on the net. The right advice can make a big difference in your life, but you need to be sure of the facts, before you act.
 
Well, that’s it for today. Til next time, my friend, be well. And have a great weekend!
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

While reviewing a number of news items and health related blogs, in preparation for my own blog, I came across an interesting study. This was done by Dr. Zhang and his coworkers at the University of Edinburgh, under the auspices of the Ostearthritis Research Society International. What Dr. Zhang and his collaborators did was to identify 25 different treatments used for the symptoms of osteoarthritis.
They divided them into non-pharamacologic, pharmacologic and surgery categories. So far, so good.
 
But what made this study uniquely useful was that they assigned each treatment a number, a percentage based on the available evidence for effectiveness in the literature. In other words, each method, drug, or surgery was an EVIDENCE BASED RECOMMENDATION. By referring to the number assigned, the reader can get a pretty good idea of how much evidence backs up each item, and can compare one 
against another.
 
In the past, most recommended treatments were based on individual experiences of the practitioner. Right or wrong, it was still anecdotal. But with this study, we can base recommendations on the collective experience and multiple sources of the medical literature. This adds a great degree of confidence in the expected results for a specific treatment. In other words, we’re not guessing what works–we now KNOW, based on evidence, not anecdote.
 
Among the non-pharmacological methods that enjoyed the highest levels of confidence were: EDUCATION & SELF MANAGEMENT (ie., what you’re doing right now): (97%), EXERCISE (96%), WEIGHT LOSS (96%), WALKING AIDS (like canes): (90%) and referral to
PHYSICAL THERAPY: (89%).
 
Imagine that! The very things that I’ve been telling you, the very things that I’ve always promoted, were the most beneficial to patients, based on all the available evidence. Am I surprised? No. But I am gratified to see the “occular proof,” as The Bard said. 

Some things are basic–not because they’re simple, but because they’re fundamental, the things on which everything else is based. These basics are available for you in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, which you can get for yourself at http://drbillsclinic.com/eliminate_knee_pain.html
 
And the best exercises ever prescibed for the relief and prevention of knee pain are laid out for you at
http://drbillsclinic.com/exercise_eliminate
 
Everything I write has been based on evidence I’ve acquired through a lifetime of practice, the world orthopaedic literature, and my own personal experience, as a patient, myself. Don’t guess, when you can KNOW. Then, you can KNOW what it’s like to have your pain disappear!

That’s it for today, my friend. 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