Re: One Vote Against Exploratory Arthroscopy

[Guest guest]

Ann:

Please don't take this Post the wrong way. I'm just

playing " Devil's Advocate " a bit. It'll probably come off a little

nasty, but that is not the intent. Anyway, here goes...

I understand that your lateral release temporarily relieved your

pain, but I can't help but be struck by the fact that you're no

better off now than you were before the initial surgery. Yes, you

can blame it on any number of confounding factors, but that doesn't

help explain why your knees are still so bad.

From my perspective, it is possible that the lateral release you got

in '95 toppled the first domino (as it were) and began this 8-year

battle you've been fighting.

I've had enough long conversations with my doctor in Connecticut,

and read enough books and articles to be able to say, with

confidence, that most surgical procedures do not help people with

chronic knee problems. Catastropic injuries to knees require

surgery -- " bad " knees don't.

I feel the same about cortisone injections. With very few

exceptions (if any), cortisone shots have no place in the treatment

of bad knees. Yes, they will reduce swelling, but at tremendous

cost to the treated area. Cortisone weakens the very structures

that it is supposedly helping, leading to laxity in the joint and

chronic weakness in the connective tissues.

Furthermore, reducing swelling does not help damaged tissue heal,

quite the contrary - inflammation is your body's way of helping

itself heal.

The goal should be to cure the disease (damaged tissues), not treat

the symptom (inflammation).

Again, I am not trying to be mean here, nor am I trying to bring

anyone down. Just the opposite. I hope that by being as adamant as

I am, I can help others avoid the nasty downward spiral of surgery

after surgery after surgery, with the only ray of hope (if you can

call it that) being a total knee replacement when you are finally

out of options.

Wow. Sorry guys -- I went a little bananas (again).

Chins up everyone! We'll get you all fixed up!

Take care,

Doug

dougfromct2002@...

> Doug -- Generally, I agree with you. But I did have a lateral

release (which is done by arthroscopy) in '95 and that did fix the

problem I had then. However, I only had a teeny piece of loose

meniscus (which he removed), so he didn't make any major changes to

the structures inside my knee.

>

> I'm going to have surgery Jan. 6, and this doc is really hot to

cut off part of my meniscus. I have a horizontal tear, and he says

this is probably what's causing the pain. However, I've read that

meniscii don't have pain nerves, so I don't see how it can be the

cause. The latest MRI (a few weeks ago) also showed a " possible "

bone spur on the lateral edge of my kneecap. Now, to me, if you've

got a bone spur rubbing against either hard or soft tissue, that

could definitely cause the pain I've been having. So I'm going to

tell him that if the bone spur is significant, I only want him to

shave that down & leave the meniscus alone unless it's actually

broken into pieces or is about to fall apart.

>

> I did know someone who had CP smoothed down & it worked for her.

But I agree. Any removal of anything inside the knee is going to

eventually lead to arthritis and a new knee. OTOH, I really can't

get around, I can't get any exercise, and I'm desperate. I'd rather

take a chance on making it worse than keep going this way. If he

does cut out part of the meniscus and it makes it worse, then I'll

go back for a unicompartmental replacement. (Remember, I'm 61 -- if

I got a replacement and got the new ceramic material, it could last

till I'm nearly 80, and by then they'll probably have better stuff.

As it is, my knee pain is forcing me to get old before my time.)

>

> Ann

[Guest guest]

Great advice Mark -- thanks. I second that!

Seriously, be forceful about it. A sentence like, " I'm really

sorry -- I know you have other patients to see, but I am still not

clear about x,y & z " can make all the difference. Be nice, but be

persistent.

Unfortunately, with our healthcare system as it is, you have to

demand as much time as you require. It is too important to let them

shuffle you out the door.

HTH,

Doug

> Sophie,

> Demand that your doctor explain everything to you in detail and if

he won't, get copies of all of your records and get a second

oppinion.

> Most docs, I have found take it for granted that patients know

what they are talking about.

> When this happens, throw up your hands and demand the proper

attention. Block the door if you have to.lol

> Mark

[Guest guest]

Mark:

Yep. I've heard that many doctors are paid by the insurance

companies to " keep costs down. " In fact, we had a pretty lively

discussion of this subject a while back.

It certainly explains the " take some Aleve and go away "

prescriptions that some of these guys give.

It is so pervasive (and I'm so paranoid) that I almost think it is

wiser to go to a doctor that isn't affiliated with too many

insurance carriers. My doc in Connecticut is only in one or two

insurance networks. I had to see him " out-of-network " and pay 30%

out-of-pocket. I guess he spends " too much time " with his patients

and it costs the insurance carriers too much money.

Like you said, imagine that...

- Doug

> Just another quick comment about the comp doctors is to remember

that they get paid by saving the carrier money.

> I know one doctor who is a friend of mine who told that the comps

won't send him any more patients because he sided with the employee.

He was told that he was costing them too much money.

> Imagine that.

>

> Mark