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What Your Doctor May Not Tell You About Knee Pain and Surgery    by Ronald P. Grelsamer order for
What Your Doctor May Not Tell You About Knee Pain and Surgery
by Ronald P. Grelsamer
Order:  USA  Can
Warner, 2002 (2002)

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* * *   Reviewed by Mary Ann Smyth

'Doctors are earnest and intelligent, are blessed with an excellent memory, and are dedicated to making people feel better. For the most part.' That fragmented sentence caught my attention. From the beginning paragraph and the title of the first chapter 'Why Doctors Misinform You,' I started questioning the necessity of the arthroscopic surgery performed on both my knees over a decade ago. I expected this to be a book I would skim through. But each time I started to skim, I found a pertinent fact or explanation of interest to myself or to someone I know.

Dr. Grelsamer states that not every orthopedist, rehabilitation doctor or physical therapist is expert in the knee - and for some doctors, it's very tempting to recommend surgery, for monetary reasons. I was taken with a sentence in the acknowledgments. 'Perhaps the best medical advice I ever received was ... to greet all patients as though I'd been waiting all day to see them and to dispense advice as if each were a friend.' Obviously Dr. Grelsamer does not think a lot of his colleagues received or follow the same advice.

In the 1970s, an entire book was devoted to the knee. Today, there are three textbooks devoted to the subject of the kneecap alone ... which I thought excessive until I read the chapter on kneecaps. I had to read some of the explanations more than once to understand them. The human body is a miraculous creation and its workings are intriguing. I now understand my own limitations and why it is hard for me to run. I'm not trying out for the track team, so that is not a problem. But I like understanding why my knees work the way they do. And that pain is not necessarily something I must run to the doctor about immediately.

I learned that arthritis can flare up and cause great pain, but that, most of the time, the flare up will subside. An operation is not always necessary. Nor is a replacement. Hot and/or cold applications and a lot of patience are usually all that are needed. And over the counter drugs work the same wonders as the expensive medications. I'm now looking into what I take in the interest of saving a lot of money for the same result. The author discusses the fact that a malaligned kneecap is often mistaken for torn medial meniscus. He laments that x-rays are taken with the patient lying down, when the correct diagnosis could be reached, without an MRI, if the patient stood. Medications are discussed, as well as insurance companies, and what they will and will not cover. There is advice on how to find the right knee doctor, and common questions are answered in a section at the back of the book.

Dr. Grelsamer questions the overuse of MRIs. And explains just what 'torn cartilage' really is. Did you know that arthritis is, by definition, a wearing down of the lining on the ends of bones? I didn't. And gratefully accepted my orthopedist's statement that he had scraped off as much arthritis as he could when he operated on me! I believed him when he said I would need a knee replacement within five to ten years on my right knee. Fortunately for my peace of mind, I feel that both my surgeries were necessary. But I question that comment about scraping the arthritis, and about needing a replacement. The ten years are up and I still walk three miles a day and live in a house with steps.

This book is a treasure trove of information, presented in layman's language, and with a delightful touch of humor thrown in. A copy should be on every home's bookshelf. If you are not suffering knee pain at the moment, wait. You probably will. Most of us do, at one time or another. And you should be well informed before seeking help, and be able to understand when to seek help. But a note of warning - don't loan this book out; you might not get it back!

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