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IN YOUR PRIME
Primum No Nocere
Q. I'm in my 80's and managing fairly well, except for two bad knees!
There is rigidness (sic) and some pain. A surgeon wants to put steel rods in
both legs, from hips to ankles. Here's my answer: there are fine doctors; in
addition, there are those who shouldn't have medical licenses.
A. Student doctors, on their first day, are commonly told: "Half of what we
teach you here is wrong-unfortunately, we don't know which half."
In other words, medicine is this evolving discipline. Treatments, approaches
and beliefs constantly are changing. Writing recently in The New York
Times magazine, Dr. Lisa Sanders says, "The history of medicine is a long,
serpentine narrative of the death of old ideas giving way to the birth of new
ones."
Currently, medicine is in the midst of a veritable revolution, during which
every idea and concept is examined, questioned, and challenged. At the head
of a notable list is surgery, once believed inviolate, the answer to every
patient's prayer. Here, from a report by Amy Docker Marcus in the Wall
Street Journal is a sentence that will rock my correspondent's (see above)
world:
"Research is calling into question the value of a wide variety of common
surgeries.Doctors who used to recommend operations to treat arthritic
knees.are telling patients to either wait or skip the surgery altogether."
Following nine consecutive seasons of high school, college and Army
football, I am the owner, half a century later, of two fickle, even gimpy
knees. When walking our dog became painful a few years ago, I visited an
orthopedic surgeon. He recommended surgery (no surprise here), then
scheduled a CAT (computerized axial tomography) scan: a sophisticated,
and expensive, x-ray. I thanked him, and left.
Back home, I climbed into a small backyard pool. Every day, I walked in
waist-high water, lifting my legs and forcing my body forward against the
water's pressure. I did this back and forth: 80 times each session. I was pain
free after three months.
Today, working with a certified strength trainer, I am able to routinely lift
350 pounds with those once weakened, chronically cranky knee joints. Next,
this further confession: 1) son Paul is a board-certified internist and
emergency room doctor. He approved my uncommon therapy, saying:
"We'll wait, and we'll watch." 2) Further, I am a believer in the late Albert
Schweitzer, M.D., who taught, "You are your own best doctor."
No one else cares as much for your body as you do, which brings us next to
responsibility. The question becomes, do you wish for the magic bullet, the
quick fix? Do you want the surgeon with his knife to make you well, or are
you willing to invest time and effort, to work hard, pushing yourself to
reclaim health and strength?
"The patient has to want to not get to surgery," one rehabilitation specialist
tells reporter Amy Marcus.
Now, every year some 650,000 patients in the United States choose to have
arthroscopic knee surgery for arthritic knees, at a cost of around $5,000 per
operation. Last year, a study showed those who had a placebo version of the
surgery (they actually believed they were operated on) felt their knees were;
well, as good as new. So much for the merits of this particular surgery.
Finally, this from Dr. Lisa Sanders: "Every week's (medical) journals and
patients challenge the old knowledge and sometimes provide the new. It's
how progress is made in medicine, one answer at a time."
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Outrageous Associations
