Word: kneeing
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Dates: during 2000-2009
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...routine case: Manuel was an office worker, 31 years old, a little overweight but in otherwise good shape. The two half-inch-long incisions I made on his knee doing arthroscopic surgery had not healed when he came to my office a week afterward to get his stitches out. So I had him come back a week later, then two more weeks later. The knee joint was ok but at the fourth week I was still staring at two gaping holes in unhealed skin. They were like cuts on a cadaver; it was creepy. There didn't seem...
...bacteria in, I had kept Manuel on oral antibiotics. But I recalled an experiment done with lab mice bred in a sterile environment. Without any bacteria around they couldn't heal cuts in their skin. Maybe my antibiotics were suppressing some bacteria that were needed to coax these knee wounds to heal. So I stopped the antibiotics and brought Manuel back a week later. No dice - still no change...
...sixth week Manuel, too, was nervous about his knee. He looked a little thinner, a little pale. Nerves? I asked about it. He said he had lost some weight - but he had been trying to. He added in a mumble, "maybe it's just water weight...
...well nor very quickly. The swelling takes months to go down, the muscles take even longer to strengthen. Good patients often complain, "It was better before we started," in desperation or anger, before they see improvement. But with plenty of therapy, braces, exercises and one or two operations, this knee does improve. It's often tough going, though, and patients have to stick with you. I like to be straight - "It gets worse before it gets better" is what I tell them. Susan's style, her history and, somehow, most telling, the way she treated her son said...
...punted. I told her there was nothing I could do differently than her last three orthopedists, but I could refer her to another who might be able to help. A certain Dr. Brown, whom I'd known as a resident, had been particularly interested in her type of knee problem...