Be nice to people. This changes the whole environment.
- Manlobbi
Stocks A to Z / Stocks B / Berkshire Hathaway (BRK.A)
No. of Recommendations: 5
Back in November I somehow messed up my knee, resulting in about 6 weeks of excruciating pain, using crutches and a cane to hobble around, inhaling more Advil and Tylenol in those 6 weeks than I have consumed in my 6+ decades of life. Got an MRI after seeing an orthopedic surgeon, knee preliminarily diagnosed as a torn meniscus. On my second visit he calmly looked at the MRI and said "Huh. You don't need surgery. I am surprised.", and then started to leave the office. Pestering him with questions got me no answers as what to do next, given my leg was still clearly compromised. I wish I could say that this was an outlier but several years ago I went to an ortho guy for my feet, as cramping of my toes was causing damage to the joints. After Xrays, all they said was you are not ready for surgery, come back when you are, and would not answer any questions about how to keep it from getting worse, not even suggesting someone to call. I found that on-line, using magnesium supplements. Obviously, navigating the medical profession is not a skill of mine.
It was suggested that I reach out to a sports medicine professional, as I was very active in competitive sports and wished to keep an active lifestyle. Heck, I at least wanted to continue being able to walk without support of a cane. I was fortunate to find someone who has been amazing, though it certainly was not easy to find him, finally resorting to my Facebook sports group to get recommendations. Plugging "sports medicine" into a Google search or even my insurance site only brought up physical therapists, but getting names allowed my to access their information directly. Absent a similar Facebook group, call your local university sports coach and ask him. My Dr. is the sports medicine doctor for all the local universities.
It seems as though my knee basically went out of alignment. Somewhat chiropractor like, after checking my range of motion he made a simple painless adjustment that instantly made things much better. Showing him my foot issues, he linked the two issues, suggesting that my knee problem was because of bad feet. Over several appointments and more xrays, he has adjusted my feet with near miraculous results, and fitted me for inserts for my shoes. He diagnosed a possible need for foot surgery to remove a bone spur created by the toe cramping, AND suggested someone to do it, but we are waiting to see what the impact of the inserts are, given how improved my feet are. While my knee doesn't want to stay aligned and will probably need physical therapy to strengthen the muscles, life is so much better, and am walking 4 miles/day at a decent 18 min/mile pace with moderate slope. Sadly no more competitive sports for me until knee alignment is addressed, but the Summer tourism adventure is back on track.
It could be that this doctor is simply a bit of a medical professional unicorn, preferring to find the root cause of a problem rather than cut or prescribe. His credentials are insane for someone who bills as a GP, being an MD, PhD, with an extensive Ortho fellowship. No idea if he is typical for sports medicine, but do yourself a favor and check out your local version if keeping moving is a goal for you. Sports medicine is not just for jocks.
IP,
wishing I had known about sports medicine decades ago
No. of Recommendations: 1
If a doctor won't answer my questions, I'll never return. I'll find someone else.
I don't care about bedside manner. If they're good, they can be as rude as they like. But I demand answers. That's what I'm paying for.
Glad you found a good guy. Not sure I could get a university coach on the phone, but it's an interesting idea.
No. of Recommendations: 0
Not sure I could get a university coach on the phone, but it's an interesting idea.
Highschool then. They are all dealing with injuries.
Glad you found a good guy.
I didn't think it would ever happen. I guess miracles do happen.
IP
No. of Recommendations: 3
A few random thoughts on torn meniscus, which I have as well:
1) As it happens, a friend just told me this morning about this study from Finland that calls into question the benefits of surgery for it, which is a very common surgery. I have no idea the legitimacy of this study myself, but I have found my engineer friend over the years to be a knowledgeable and credible source of information who does not go around saying things lightly (and his wife is a doctor).
https://www.helsinki.fi/en/news/health/one-worlds-...One of the world’s most common knee surgeries does not help and may even be harmful
Partial meniscectomy does not improve patient symptoms or function, reveals a 10-year follow-up of the FIDELITY, a placebo-surgery controlled trial.2) I was diagnosed probably 20 years ago with a torn meniscus. I have managed to be mostly pain-free since, including playing a lot of competitive sports (mainly beach volleyball). At the time, the doctor told me he could set up an MRI machine outside a movie theater (remember those?) and probably half the people would have a torn meniscus, though most wouldn't know it because they weren't active enough to feel it. I have mainly managed it over the years by backing off when I start feeling pain, and
3) I have found it very helpful to wear a knee brace when I sleep. I tend to sleep with a lot of tension (teeth-grinding etc.) and found myself waking up in the night with my leg twisted into positions that would bring pain. Sleeping in a knee brace has helped quite a bit. I practically sleep in a football uniform these days--knee brace, ankle brace, wrist braces for carpal tunnel and mouthguard for the teeth grinding--but it all has a purpose and it all helps. Aging isn't the most fun process, but as they say, better than the alternative.
No. of Recommendations: 3
A few random thoughts on torn meniscus, which I have as well...
Sorry if I wasn't clear, but while the preliminary thought was torn meniscus, that isn't what I have. Which makes sense to me as there was no mechanical action that caused the pain. Instead it appears to be from bad feet, probably from poorly fitting used shoes as a kid and heels in my 20's and 30's resulting in a knee that pops out of alignment. Thus the great improvement from gentle manipulations of my feet and knee, and hopefully long term permanent corrections from the shoe orthodics that have been ordered.
...wrist braces for carpal tunnel...
I used to wear these so I didn't wake up in screaming pain in the middle of the night. Was told I would need surgery, but the wrist guards and alternating computer mouse hand put that off indefinitely with tolerable pain. I am big on dietary supplements and started taking Alpha-Lipoic Acid, (ALA), for brain health. It's a compound that is used in meds for neuropathy as well. About 2 weeks in to starting the supplement, I realized I had not had carpel pain, which would still happen even with the braces. Googling the reviews for ALA, the only recent change I had made, I saw anecdotal evidence of lessening/elimination of carpel tunnel and sciatica pain, and increased my dose from 600 to 900mg/day, which was the amount that was reported as being used for relief. I quickly put my wrist braces to the side and almost a decade later still don't need them other than as preventative during trigger events such as driving long distances.
Of course, that is not as monetarily gratifying for your doctor/surgeon. ALA is pretty cheap and over the counter. I like the soft gel capsules from PuritainPride.com, as they are least likely to give bad tasting burps. TMI, but honestly important. You don't want to taste this stuff. I don't take meds, so check with your doctor for contraindications if you take any. DH takes the ALA as well, for brain health and diabetic neuropathy, and he is on many meds. His doctor did not prescribe it, but told him it probably wouldn't hurt, and he has found it has reduced tingling. YMMV.
IP,
big into addressing root causes, not just symptoms
No. of Recommendations: 1
Not all meniscal tears are equal. The direction and the extent of tears dictate symptoms. Some are radial and some are arciform. The main reason for surgery is recurrent displacement of an unstable segment causing significant symptoms with prolonged recovery.
No. of Recommendations: 1
Not all meniscal tears are equal.
My MRI showed no meniscal tears though the orthopedic surgeon I saw that ordered the MRI thought it probable based on my pain level and restricted movement. When you are looking for an opportunity to cut, that is what you see. On my second visit, with MRI in hand, he was visibly disappointed that no surgery was needed. My Xray, taken at the ortho doc's and immediately available to him at my first appointment, showed misalignment, which he missed. The non-invasive treatment I received from the Sports Medicine doctor who diagnosed and treated the misalignment, based on the previous tests, has been near miraculous.
That said, the SM doc did say that foot surgery MAY be necessary, and has referred me to a surgeon that will do the job if needed.
IP
No. of Recommendations: 1
One wonders how many decisions to operate are influenced by upcoming boat payments...
I am not sure how misalignment is used in this context, but another phenomenon is a misalignment of the surface of a meniscus along a tear. This small jog in the surface can function as a micro-plane and shave off over time the femoral head cartilage.
No. of Recommendations: 1
I am not sure how misalignment is used in this context...
As in out of alignment. The fix he does involves gentle pushing while I push back gently. Kind of like a chiropractor, but an MD, PhD.
One wonders how many decisions to operate are influenced by upcoming boat payments...
Yup. If it were about helping people, one would think they would guide you to the right place instead of just telling you to come back when ready for surgery. One experience like this, weird...2 is insane. I guess it comes from trying to be proactive and not wait until life is unbearable. But now I understand that an orthopedic surgeon is not the place to go and sports medicine is.
IP,
happily not in chronic need of medical professionals
