Dr.TO 873

Kansas Center Hunter Dickson has been playing with a shoulder injury, Kate Middleton has cancer or is it fake? Shohei Ohtani translator stealing money, and teenage girls v teenage boys talking about injuries and being vocal.

Episode Transcript

(00:00):
It's tip off time for Doctor tO. Sorrel and Inside Sports Medicine on
ninety seven to one The Freak.Doctor Sorriel, one of the nation's leading
orthopedic surgeons and former head team physicianfor the Dallas Mavericks, bringing his unique
sports insights and stories from inside thegame. With special guests from the world
of professional, college and high schoolsports and sports medicine, the Doctor breaks

(00:21):
it all down. Buckle up yourchin strap and tighten your laces for the
most informative ninety minutes in sports medicine. It's kickoff time for Inside Sports Medicine
with Doctor t. O. Sorrialon ninety seven to one The Freak.

(01:08):
Good Saturday Morning. Everyone, GoodSaturday morning, and welcome to Inside Sports
Medicine Live, Episode eight and seventythree. For those keeping track, I'm
your host, Doctor t O.Sorry aw. This is your sports medicine
current events show where the topics areripped right off of the sports desk.

(01:30):
Over the next ninety minutes, you'regoing to be informed, entertained, and
hopefully learn something new. You'll havean opportunity to call in or text in.
We'll do our best to respond toall of the communications. We have
a full house this morning, doctorBrad Ballard, doctor Scott Blumenthal, Daniel

(01:55):
Hunter, Garrett. The only personmissing is Blaylock. Did he agree?
I wasn't quite sure if he hadadmitted to being able to be here today.
He had a late night last night. It was his birthday celebration,
so he slept in this morning.Woo. We had a wonderful pre production

(02:15):
meeting. I think in the nottoo distant future when we go to podcast,
we'll probably start the podcast at sevenand then go on the air at
seven point thirty because we're always hereat seven anyway for the pre production meeting.
So welcome to the show. Ifyou are a regular, thank you

(02:36):
so much. We love the loyalty. If you're new, stay tuned,
Call your friends tell him this isIt's gonna be one of our better episodes
because there's so much in the news, some of it not actually sports medicine
related, because we are in themedical world. I think we're going to

(03:00):
comment on this princess cake thing becauseeverybody's speculating except Brady. Doctor Mallard did
not even know. I had noidea. Listen. The reason why I
enjoyed the pre production meeting was becauseI got educated on what's going on in
the world. So the things wetalked about wearing your hat backwards, but

(03:21):
there are certain hats you can't dothat. Yes, wearing sneakers with a
suit, and apparently they're the rightkind of shoe matters. The things that
we talk about so early in themorning on a Saturday are mind boggling.
Oh and it's stuff that we've thoughtout fully, because you were like,
well, Scott was talking about wearinghat backwards, Like, would you say

(03:42):
grown men shouldn't do that anymore?Yeah, it's one of my pet peeves.
Okay, it's onepad. I'm like, dude, I'll walk a hand
backwards, but I'm wearing a captoday. You can't see it. But
they was like, we'll put thisone backwards. I was like, yeah,
but this isn't the one to actuallyput backwards. Me. I didn't
know that truckerhead. I'm not puttingthe truck back now Hunter knows because we
talk about the hat game, like, I'm not gonna put a trucker hat

(04:03):
backwards, but what's the trucker hat. I don't know that is that the
kind of front the beaks yeah,yeah, not the beak. It's called
the bill. The bill. Soyou guys, I think that's really easy
to get those two confused at ourage, if you're of a certain age.
Yes, I can see how thatis. I rely on you guys

(04:26):
for my current events. Yep,clearly. Well this is a current events
show. So uh, the topicsare ripped right off the sports desk,
off the sports desk, better thanI thought it was a sports page.
Sports desks? Do they still havesports desks in I don't know newspaper offices.

(04:46):
I really don't know, Scott.I assume that's where that came.
They don't even Yeah, they don'thave sports. They don't have newspapers anymore
hardly. I came across the DallasMorning News the other day at the doctor's
office. I was there, andI thought it was the coolest thing.
I miss sitting there with the sportspage, drinking coffee and reading from there
and reading from Yeah, I missedthat. They still have it. The
place where I play golf, they'llhave a couple Dallas Morning News sitting out.

(05:11):
Uh huh. I get on myphone, so I read the news
on my phone. No, becauseI'm not I will not subscribe to it,
oh, Dallasnews dot com. Iwill. They shouldn't be advertising for
them. But so I am goingto go sports medicine right off the bat,
and then we're gonna do popular culture. The Center for Kansas what's his

(05:38):
name, Hunter Dickinson, Hunter Dickinson, seven foot two, has been out
missed the UH miss the tournament,their play, their the Big twelve Tournament,
Big twelve Tournament because of what theydescribed as a shoulder separation. And
we've actually had an entire show onthe different between a shoulder separation and an

(06:02):
ac joint separation. Now that soundsawfully heavy for a Saturday morning, but
it has been an ongoing area ofconfusion for decades. And I blame the
PR people. I blame the thesports information people for these various schools,

(06:25):
as well as the athletic trainers forthis confusion that moms and dads to this
day still get them mixed up.And part of it is medical nomenclature.
So I wanted to start with thisbecause this is really the meat of the
show. A shoulder is a balland socket joint. It is very obvious

(06:49):
when the ball comes out of thesocket. It is a dislocated shoulder.
You've seen it. I hope you'venot had it, because it's very painful.
But a older dislocation is somewhat ofa common problem in the world of
sports medicine. Dwayne Wade yes oneof my least favorite players ever ever and

(07:12):
will always be that because of theway he and Lebron were mocking Dirk when
Dirk had a cold, and I'llnever forget that or forgive that he had
a shoulder dislocation and the shoulder wasout and he was wheeled out on a
wheelchair until they were able to popit back in the ambulance. It's a
traumatic thing. I mean, itis terrible. There's no question when you
have it. I mean it's prettygood ball comes out of the socket dislocation

(07:36):
sometimes the shoulder is so loose thatit kind of slips in and out.
And when it slips in and out, the medical term is subluxation, but
nobody ever uses that publicly because Idon't know, it's just a hard word
to say subluxation. But trainers backin the olden days, in order to

(07:59):
simply the situation, called it aseparation. Oh yeah, his shoulder separated.
Well, that is what this youngman was being braced for. He
was wearing a shoulder brace in pregamewarm ups and he wore it when he
came back to play. So obviouslyhis problem was a subluxation problem in that

(08:22):
the shoulder slipped in and out.We see this in college football and high
school football. We see this ingirls basketball. It is a very common
problem because inherently the ball and socketis unstable. I mean inherently it is.
So here's the point of confusion.In our world, a shoulder separation

(08:46):
has to do with the ac joint, has to do with the clavicle,
the collar bone. So if ifyou are skiing and you take a tumble
and you fall on the point ofyour shoulder and the clavicle kind of pulls
up, Yeah, that's a shoulderseparation. That's that's our world. And
there's there's really not a harness forthat. I don't know. Hockey players

(09:09):
get it all the time, footballplayers. The whole reason football players wear
shoulder pads is to prevent ac jointinjuries. That was it, That's the
whole reason. So and so again, I thought that this was a kind
of a good topic to start offthe show, to allow our new listeners

(09:30):
to understand. This is what wedo. We just we we we explain
the difference between the separation and aand a dislocation and whatever. If don't
even get me talking about high anklesprings. But that's for a whole other
day. That's for a whole otherday. Now along those same lines,

(09:52):
watch where I'm going to go withthis, Princess Kate, I'm back,
I was Okay, I'm back.Yes, So did you know the shoulder
separation controversy? Yeah, but don'treally care. Yeah, as much as
you guys are not alone to spineScott's Yeah, Scott will check out for

(10:13):
a minute. Scott is globally renowned, world renowned spine surgeon. In fact,
I took my wife to him yesterdayfor a consult. Thank you very
much. You were you were verygracious, and you were very spot on.
Actually we talked about it on ourway home in the car. Thank
you very much for seeing Karen yesterday. It's always a pleasure. But the

(10:35):
world of sports medicine, shoulder separationsublexation means nothing to him. No,
I know what it means because I'mtrained in board certified as an orthopedic surgeon.
But it is not part of myworld. Yeah. Well, so
way back in the olden days.The reason this show is on the air
is because of a misnomer, verymuch like what I just mentioned to you

(10:56):
guys. It was an Emmage Smithwas the running back for the Cowboys,
So that tells you how how farback it was. And he had a
terrible, terrible ankle injury and uh, on the in the Dallas Morning News,
speaking of the Dallas Morning News,Uh, the blurb was, MRI

(11:18):
was positive for a third degree anklesprain, but fortunately no ligaments were damaged.
Flag flag onto play. So backcheck, you can't have a third
degree ankle sprain without having ligament damage. But that was the spin. That
was the pr spin on it,and it was obviously a misnomer. And
I got to the point where Isay, you know what, somebody needs

(11:39):
to set the record straight. Andhence the opportunity came up with ESPN to
have a radio show. And herewe are twenty three years later. Oh,
it's broken. At least it's notfractured. Yeah. At the same
time, at a patient say thatthe other day, like said, I
think I think my my son hasa fractured shoulder, but I don't think
it's broken. Yeah. Yeah,so episode one back in the days when

(12:03):
I was in the closet, andGod always laughs when I say it that
way, this come out. Yeah, the very first studio was literally a
closet. That was episode one Andwasn't Arlington, wasn't it. I can't
remember. It was no, no, no, that was later. I
think it might have been in LosCleanas. In the very very beginning.
I thought Lost Cleanus was second andArlington was first. It was I thought

(12:24):
initially it was down by duders twentythree years ago. I can't remember.
I just can't remember. But separationand suble location and sublo case there are
two different joints, two different waysof managing it, exactly. There are
two different animals. And I don'tand and often, you know, the
the athletic trainers will kind of simplifyit to the moms and dads and say,

(12:46):
y oh, his shoulders separated.No, it was a different animal,
different animals. It just slipped inand out of socket and we got
to protect it. Okay, you'redone with that, refocus, I'm back.
You derailed us there with a noI wanted to give the new listeners
a taste of the stuff we talkabout and how it's relevant to them.
But that you teased Kate, andI'm going to go back to Kate.

(13:09):
Now, do you like a proRoyals person? I mean, you like,
like the Royals are cool. I'mfascinated by the Royals. I'm too,
I'm fascinated. But Brad, youknow who they are. They seem
to be having an epidemic of cancersin the family though, yeah, that
that they're not saying which ones,but they're they're cancers. Very secretive,

(13:33):
yeah, you know, and sothere's all this like, oh, you
know, respect their privacy and thisand that. I'm sorry, you're born
into this, you're born into publicand you know, be respectful, absolutely,
but people want to know what's goingon. So come on. So
you were saying sublexation, separation andyou said hens kind of a segue into

(13:58):
Kate, so that the segue isobviously Kate's problem has nothing to do with
her shoulder. However, the medicalinformation that comes out. Remember the episode
we did oh gosh, maybe tenyears ago on sports medicine Secrets, Yes,

(14:18):
and one of the things that thatwas on the top of the list
is don't believe what you read aboutmedical conditions, especially when it comes from
a single source. So uh,and we did. The reason I did
that was because Tiger Woods won theUS Open on a broken leg. That
was what came out of his report. That was what came out of his

(14:39):
camp. He didn't win the USOpen on a broken leg. He had
bone marrow edmon MRI, which somepeople called the stress reaction. They went
from stress reaction to stress fracture,then they went to fracture. Right,
broken leg. He played on abroken leg. No, he really didn't.
No, so but but the pointof that story is, don't believe
what medical information that you get froma single source. And the Royals obviously

(15:03):
are a single source, and they'revery protective everything and calculated about what comes
out and how it comes out.The story started with her having a scheduled
abdominal surgery that required her to stayin the hospital for two weeks, and

(15:26):
the speculation was, certainly amongst uswere orthopedies, for God's sake, so
our patients barely spend the night inthe hospital. What could it have been
that required a two weeks stay?And the paparazzi and the social media people
just went nuts. I watched itfrom a distance, just simply as a

(15:50):
doctor, and you as well,same thing. I mean, watched it
from a distance as I could.I have you said that, you know
that, you do know, Butour listeners made that outside the US,
patients stay in the hospital longer forthe same thing that they would have here.
So if you would be in thehospital four days for something here,

(16:11):
you would be in the hospital twoweeks, maybe even three outside the US.
Sure, some it's the way,but you didn't know this. Some
it's the way that hospitals get paid. I get paid the longer patient stays
in the hospital, like you know. That's the case in Germany. So
an operation that I do here,they stay in the hospital four times is

(16:33):
long in Germany because that's the waythe hospitals get paid. And by the
way, we used to have itlike that here. Oh yeah, back
before managed care and all this otherstuff. The hospitals used to get paid
the longer you stayed in But mancare says you've got to get out in
twenty four hours. So be itas it may. The wheels start turning.
It probably was not some minimally itwas something that required an incision.

(16:56):
I agree. So it's initially mythought was, h you know, done
having babies, tummy tuck some gwhat oh yeah, like plastic surgery tummy
tuck. But even then, youknow, we do they do tummy tuck's
in our hospital and they go homeright the next day. But if you're
the future of England, baby obviouslywas not. It was something more serious.

(17:21):
So let me catch up our listeners. I'm sorry, I'm sorry,
inter because we're gonna have to goand break. So she came out yesterday
for Brad, for doctor Billard becausehe didn't know what was going on at
all. So it all started withthis procedure a couple of months ago that
required her and then she hadn't beenseen since, has not and so everybody's
wondering what's going on with Kate whatever, whatever, whatever, and then she

(17:42):
comes out yesterday and say and saidthat she had cancer or they discovered she
had cancer. So now everybody's ina tizzy. It is a lead story
on pretty much every news tellcast,which is why we're talking about its medicine.
Man, quick little break. We'recoming right back and talk more about

(18:03):
Kate, I think we've lost ouraudience. I think now we've pulled it
back. I think we lost themwith fun and has been here. You
have me collect welcome back. There'sa reason why we're playing Taylor Swift,

(18:30):
and you're gonna find out a littlebit later in the show. Look,
I like that would make me stickaround. Like that teaser, it was
like the best I've ever heard goldRadio Goal more listeners today, money money,
Play that again or turn it upagain? I love that song?
What is it? What you Belongwith Me? Taylor Swift like her biggest

(18:53):
hit, you Belong with Me?This is your biggest hit, one of
them. I didn't know. I'mon your side with this. I've been
under a rock all morning. Youhave been under rock all morning. Ask
your daughter about it? Yeah,yeah, yeah, okay. I'm I'm
definitely gonna catch grief when I gethome that I played this from both both

(19:15):
my daughters and my daughter in law. Big top swifties they are, Oh
they're big time swift. Why wouldyou say about it? They should be
supportive of your branching out your musicalgenre. Well, I'm sure that I
said something incorrectly like this may nothave been our biggest hit or something.
I will definitely catch grief over this. Welcome back to Inside Sports Medicine.

(19:37):
Two one four seven eight seven,nineteen seventy one is our number. You
can use it to text, oryou can use it to call in with
any questions or comments. We arereaching out to a broader demographic with that
intro, oh for sure. Yeah, but just wait until you see how
I bring that back to sports.Just wait, hopefully how many than the

(19:57):
NFL has. How am I gonnago from Taylor? Oh? I know
they no one on that one.Look, I don't think the NFL understood
the magnitude of Taylor Swift's involvement.She's I'm gonna say this on they knew

(20:19):
exactly what was going on national radio. I just totally disagree with you.
I think Taylor Swift is bigger thanthe NFL. She's global, She is
bigger than the NFL, and herbrand alone is bigger than the NFL.
Her brand, That's what I'm saying, guys, That's what I'm saying.
Okay, so we context, firstof all, got through the flag.
You got through the flag. We'vegot two people in a generation that's younger

(20:42):
than everybody else here. So Hunterand Daniel, do you guys agree that
Taylor Swift's brand is bigger than theNFL internationally globally? I think her scope
and reach. I mean, likeshe's stilling out shows in Japan and Brazil.
I mean, and obviously the NFLlike has go and play game in

(21:03):
these other places, but they're notsewing out of shows three bus in a
row Australia. I mean, she'splaying the entire continent of Australia and selling
out stadiums. She's much much biggerbrand than the NFL. Even at his
height, Tiger Wood's global brand paledcompared to the entertainment industries. Who was
at the top of the entertainment industrywhen Tiger Wood was at the top of

(21:26):
the sports injury industry, He paled, I say where you're going there,
that your entertainment is bigger than sports. I get it, no question,
But why through the flag was Ithink the NFL news to exactly mean,
they didn't plan it, but whenit happened, they knew how big this
would be for them, which iswhy they kept cutting to her and absolutely
yeah, yeah during the games cuttingto her, just showing her. Yeah,

(21:48):
absolutely this was and from her pointof view, it brought her an
audience that she didn't have otherwise.Like okay, uh yeah, but she
didn't need that. She didn't needit. She didn't need it. But
I mean the NFL benefited from therelationship more than way more than she did.
She did not need a bunch ofdrunk old guys sitting on the couch

(22:11):
watching football. All right, whatI mean say it's a five percent bump
in her global business. I's notgonna turn that down, but it's an
opportunity. Actually, the biggest winneris Kelsey. Yeah, because his brand,
oh yeah, went through the roof. And you know, had multiple

(22:33):
people say that they just watched thegame to see Taylor Swift. They didn't
know anything about football, didn't care, and we're just watching for it.
Just you know, when they finallybreak up, his his dating pool will
be forever changed. His ridgs justrecently increased. Yep. So look,
let's let's circle back to I wantedto finish up this princess Kate. What's

(22:59):
k class name? Middleton? It'sWindsor now, isn't it. I don't
know, but Middleton was before shegot married, just princess, princess.
I mean, I think everyone knowsthere's as Kate Middleton, Kate Middleton.
I think only you know her reallast name. Now if you keep up
with the all that stuff. Yeah, I had no idea what the Duchess

(23:21):
of Wales. Wales, Yeah,future Queen of England. I think future
Queen of England. Yes, sowell, what you mean it's not over?
That was terrible flag on your yeahmyself for that one. Yeah,
for those of you who did nothear he said, assuming it's not ovarian
cancer, because there's the speculation iswhat kind of cancer she has for a

(23:47):
young woman. Ovarian cancer is nota good diagnosis. No, you're gonna
you're going to get a call fromthe PAM. Yeah, I think I
think me on on she called youout about two weeks ago. Yeah,
yeah, so again, so Ido want to make a comment on that
later. We're trying we're trying tobe respectful here, and we're approaching this

(24:10):
from a medical standpoint, a medicalstandpoint, because this is relevant to all
of you guys, everybody who's listening, whether it's an ACL or a new
replacement or back surgery or whatever,what is it that keeps you in the
hospital for two weeks. So Scottkind of presented a couple of caveats that
we should all be aware of inthat in Europe you do end up being

(24:32):
in the hospital longer typically, andshe is the future Queen of England,
so she is entitled to be inthe hospital for an extra couple of days.
But all that put together, whatkind of medical condition could initially be
ruled benign and later after pathology resultscome back, turns out to be cancerous,

(24:53):
which is the story that we're gettingright now. And you know,
I have a theory that it's mostlikely some type of a colon cancer.
The other theory, and Scott isgoing with this one, is that it's
a gyn cancer gynecological cancer of somesort. Another one popped into my head,
yeah, is if you're doing andwe've done this, we've in anti

(25:14):
lumbar surgery. It's happened to mea couple of times where we've been doing
an abdominal surgery and we see alymph node and to just take a biopsy
of it, because it's just like, wow, that's a big lymph node
and it could be say, no, I didn't know that I didn't know
that that's a thing. I thinkthat would be the least likely of the
death scenarios we're talking about, butit has happened. So part of the

(25:37):
reason why we're talking about this onthis particular show is because we did have
an episode many many years ago aboutmedical information that comes out from a single
source, and I use the tigerWood situation typically in team settings. So
I was with the Mavericks for athree decade spam and whenever there was a

(25:57):
medical condition and we were asked toput out a press release, uh,
there was almost a committee involved,you know, the obviously the player,
the players representatives, the coaching staff, the management. So there was a
committee involved that you know, kindof spun it a different way. Yea.
I go back to what I saidabout EMMITTT. Smith. You know,

(26:19):
uh, a Grade three ankle sprain, but fortunately no ligaments were damaged.
That was a spin. Yeah,that was clearly a spin because the
accuracy was was not there. Soin a team sport, when a press
release comes out about something medical,it's it's well constructed, but there's almost

(26:41):
always a spin in an individual sport. Roger Federer, the tennis tiger Woods,
Uh, Kate Middleton there there.Don't believe what you hear because there's
no way to confirm or deny.Yeah, a few years back, got
Kawhi Leonard, Oh, Leonard andhis quaterning. Geez, what was that

(27:03):
all about? Right? Yeah,to this day, I'm really not a
fan of Kauhi because of the wayhe threw the San Antonio medical staff under
the under the busy. We knowthem well, they're one of the best
staffs in the league. You know, Tim Duncan played five years longer than
he normally would have played if itwasn't for them, for sure. And
then and yeah, Kauhi, arewe done with Kate? Well, we

(27:27):
still need to say what we thinkthe two most common scenarios would be.
So statistically, you're the one thatlooked it up. Yes, so the
most common cancers and women obviously breastby far, but after that it would
be either our colorectal or gynecologic,either uterine or ovarian, So it's either

(27:52):
gynecologic or gi that the lymph notething, it would be what do we
call it a red hering red herring, Yeah, that would be the black
swan, right, So I'm mytheory on our family thread is that this
is probably something colon related and itwas perhaps a planned colon procedure, which

(28:18):
in the back of my mind doesexplain a two week hospital stay. And
on the pathology they found something cancerouslike a poll up and hence the cancer
diagnosis. That's my theory. Yeah, I'm going with kind of logic.
Yeah, and statistically this is whatwe got. And I don't know that

(28:40):
we'll ever find out, nor dowe really care moving forward. I just
hope she's okay and her family's okayand to handle it well. And I
think that time we'll find out aboutonce. She did say in the video
that it was a major abdominal surgery. She did say with which, which
which to me is you know,if if you take a piece of your

(29:00):
colon, that's a big abdominal shys direct me is not a I mean
his director me is still significant enoughto have to recover from. Yeah,
but they're doing hysterectomies laparoscopically now,and they're doing him. They're they're doing
it very minimally invasive where you cango home in that same afternoon. Yeah,
I'm surprised. I would be surprisedthat if it was a hysterectomy,

(29:21):
that it was done open like theold days. Yeah right, Yeah,
I would be too. That wouldbe too, which again goes back to
why you're saying, go something,goes back to what I'm saying. Something
colon related. Probably. It's funnyhow our minds work context clues. Like
I tell my kids, you gotto put the clues together. Okay,
all right, one more clue beforewe leave her alone. On her little

(29:45):
video that I did watch yesterday,when she was sitting on the park bench
and telling people why they were secretiveto protect their family, and I get
that. I get that one hundredpercent. She also said that they're waiting
to start chemo until she fully recoveredfrom the procedure two or three months ago.
Now, if it was a badcancer, they would have started chemo

(30:07):
the next day, whatever, whatever. I remember when one of my patients
was in a coma, they startedchemo while he was in a coma.
What I'm talking about Ray? Ohyeah, yeah, I mean he he
was. He was in a comabecause of a bleeding issue, and they

(30:30):
discovered that the bleeding issue was becauseof a blood cancer. And while he's
in a coma, they asked herhis mom and dad, can we start
chemo now, because where there's noway we're going to be able to get
this under control unless we start.So they started chemo while he was in
a coma. So if it's somethingbad, you're going to start chemo right
away. You're not going to waitthree months anyway. Nless you're well,

(30:53):
unless you're pretreating with radiation. Mbut that I don't know. I don't
know. I don't know. Nownow now we're way off. Now we're
way off, Scott. What wasit you want to talk about with backwards
or have we already done that?I like, we're good on that.
We got so much good stuff.So someone is asking via text about infrared.

(31:19):
Yes, I like it. I'mwe use it a Texas Sports Medicine
as a recovery tool, so wehave red light therapy. I remember during
the playoffs Josh Howard. I don'tknow if you guys are old enough to
remember Josh Howard, but he rolledan ankle and we were in the playoffs,
and it was in two thousand andsix, and we were actually went
pretty far into playoffs, and Iliterally told our rehab staff throw the kitchen

(31:47):
sink out, do everything you canpossibly do short of a needle to get
him ready to play. And theone thing that made a difference in his
recovery was the infrared light. Niceand so yeah, do I believe in
it? Yeah? Do I knowhow it works? Not really, I
think And this this is one ofthe great things about sports medicine, especially

(32:09):
at the upper upper levels. We'reable to try things that we're probably the
first in the country to try certainthings because we're in that position and still
do no harm, which is thefirst, and still do no harm,
which is the first. You know, I remember on on all that we
have is not to do anymore.Elton Brand used to play for the MAVs.

(32:32):
He's now the GM over at Philadelphia. I did a fat transplant into
his arthuritic Neque what twelve thirteen yearsago, and that was unheard of.
And in the room when we didit, there were twelve people in there.
The company came up from Austin andthey had Oh my gosh, it
was It was a big deal.And now we do fat transplants all the

(32:52):
time, all the time, allthe time. Quick little break, yep,
it's eight ten, it's break time. Two one four seven eight seven,
nineteen seventy one cell number, andit's all cell number, text number,
and it's also the number if youhave any questions or comments and Pam,

(33:15):
I know you're listening, so feelfree to call call out doctor Bloomenthal.
Bring it on Inside Sports Medicine,coming right back. Kids, Hey,

(33:42):
tell me you don't like this.I don't like it. Two one
four seven eight seven nineteen seventy one. Two one four seven eight seven nineteen
seventy one is the number to callin walk come back to Inside Sports Medicine
nineteen seventy one, thirty years beforepeople who actually liked this music were born.

(34:07):
That was Scott Blumenthal, doctor BradBillard sitting across from me, Hunter
and Daniel. Let me ask youa question. Our interns are here and
Garrett's on the other side of theglass. Here's a musical question. We've
done episodes where we've played earth Windand Fire, Yes, yes, thirty

(34:29):
year ago music. Are we goingto be playing Taylor Swift music in thirty
years? I think so? Ithink so. Do you think she's got
the longevity of like an earth Windand Fire, this Eagles or Madonna?
And when you got this most momentum, Scott, It's gonna be generational.
I mean, I will help it. I will say it is my opinion

(34:50):
that music of our generation has legs, and music of this generation, with
the exception of a rare few,does not have. I don't think has
the longevity. But I do thinkcertain Taylor Swift songs, Beyonce songs that

(35:10):
are going to last forever and everand ever. I do think that.
And down the road, when Ballardis our age, he's going to look
back and say, oh, yeah, that's my my generation song. Listen,
I listened to Earth Wind and FireEarth Yeah, so I'm I'm everywhere,
with the exception of I guess.Yeah. So, why are we

(35:32):
playing Taylor Swift today? Well,we're playing Taylor Swift today. We actually
played it a few weeks ago duringthe NFL playoffs because the super Bowl before
the Super Bowl. Yeah, sowe're playing it again today because a case
came up this week at our office. It didn't involve me, and involved
Hunter and doctor Blaylock. That reaffirmedin my mind that teenage girls who are

(36:00):
Taylor Swift fans, or maybe they'renot Taylor Swift fans, sometimes make very
different one. What find one teenagegirl that's not a Taylor Swift fan?
Good one, I don't know.I bet you could find one real fast,
Okay. I bet I can gooutside, walk around and find someone
in five minutes. They're not upright now. Yeah, they're not which
which which I'm glad they're not.Find one that's not a fan, not

(36:22):
a fan, not a fan,not a fan. There's there's people awake
right now that are aren't fan ofTaylor Swift. I okay, I hear
where you're coming from. However,the point is that most of Taylor Swift's
billion people are teenage girls. I'mthinking, and so I've said this for

(36:44):
a long time. They're very difficultto treat in the medical world, especially
in the sports medicine world. AndI had a I mean, I learned
this lesson about fifteen years ago.And by the way, I'm I'm probably
gonna get in trouble with Pam becauseI know Pam's on the phone waiting and

(37:04):
at some point she was a teenagegirl. And I know that I raised
two young daughters, and I rememberthe teenage years. I have a fifteen
year old daughter. How who's tailorswift. Then she definitely knows of her
music, but I don't know ifshe's just like a Swiftie. Yeah,
flen't you send her text and askif she's a swift she's not awake?
Oh so, so my lesson wayback when is complaining of knee pain,

(37:32):
and of course I took it seriously, and I got X rays and they
were negative. And we went throughthis incredible work up and I never could
really find anything, and I wasscratching my head and I was beating myself
up, thinking, am I reallya bad doctor? Why can't I find
out what's wrong with this girl?And several visits into it, I realized

(37:55):
she didn't like her coach and herknee symptoms were manifestation of that. She
really didn't want to play, andand we went through this in now to
this day, even with that inthe back of my mind, I take
it seriously. I get the Xrays, I do the exam, I
do the MRI. I'm obligated.But it does make it a little hard

(38:20):
to treat because there are some otherthings going on that sometimes they don't share
in front of mom and dad.And the story that Hunter kind of shared
with us goes along present the case. Absolutely. So this girl doctor doctor
Bayle started seeing her back in February. Her and her friend were doing trust
falls. They're no longer friends inWorth. Her friend dropped her. What

(38:45):
does Oh, that's when you fallback? Yeah, okay, She tried
to brace herself. She came inpresented with a supercondolar fracture. Setors are
proceed with non conservative. That's anelbow fracture to the conservative treatment. It
was on her left side. Inmy job as a medic close system,
my my role is to make thepatient and doctor flow of communication smooth and

(39:06):
efficient. Get the doctor's brief historyand backgrounds, updates on the patients before
they go in there. That waythey know what they're getting into. So
then we've seen this girl probably threeor four times. Each time I go
in there ask her how are you, how's how's that left elbow doing?
And everything normally runs smoothly. Youmight get some updated X rays. But
this time, this past week,I come in and she goes, no,
it's my right elbow, and Igo hmm. I sometimes I can

(39:29):
get the laterality confused, but Igo back in to look at her chart,
look at all the past three orfour visits, and they all say
left elbow, and so I'm like, hmmm. And so me and doctor
Story all talk about this all thetime, about the we call it flakiness,
and we're gonna be really mad.Now I'm gonna get better. This
is gonna be the best half hour. This is gonna be horrible. I'm

(39:52):
just gonna We're just gonna die.Then, yeah, of teenage girls,
we're not saying and her and herher dad said that we thought it was
your left as well. Yeah,we said we thought it was her left
and she says, no, itwas my right. I'm sure of it.
And so yeah, like sometimes,especially in these situations, I gotta
be like the horse in the race. I gonna you're gonna throw the blinders

(40:14):
on a little bit, look directlyat the problem. I'm like, okay,
so we're supposed to get X rays, but now we can't figure out
whether it's the left of or andso I go and tell doctor Blaylock and
he's like, let me go inthere and talk to her. So we
completely can the X rays. Ithink she was. She ended up being
fine. We discharged her, butthe right left thing. But but more

(40:34):
importantly that the inaccuracies that come alongwith that, perhaps age group and and
is Pam on? Is Pam?Hey put her on? Oh ho hi
Pam Hi doctor. As I waspreparing for this segment, the only thing
I could think of is what areyou gonna say about this? There are

(40:59):
so many I don't know where tostart. There are lots of flags on
the place. So Pam's an athlete. She's also a patient of art.
She's been a patient for what twentyyears perhaps, And you're athlete at a
really high level. Correct, Yeah, I was an Olympic athlete. Olympic
athlete. I mean that's a that'sa big deal. Am I saying?

(41:22):
Are we saying anything that's really outof school here or what? Okay,
I wouldn't say I'm a Swiss see, but most women are fans of fellow
Swift. You have to admire her, her creativity and so forth. So
yes, I know her music andlisten to it. So that was the
first thing he talked about. ButI'm here to sort of read doctor Blumenthal

(41:45):
the riot act. Oh yeah,are you talking about last week? Huh
oh yeah, oh yeah? Areyou doing doctor Blumen. I'm good he's
sweating right now. Yeah, he'sa little sweaty, be a sweat.
I'm here to listen. By theway, my back is still doing well.
So thank you for all of that. Fantastic. So your comment about

(42:08):
the lotion or the deodorant, theall body deodorant, about the model,
Yeah, I think we just wenta little too far. I think we've
all seen new advertising from Dove andareas where you actually see regular looking people.
And I know it's not, youknow, done on everything, but

(42:29):
personally, I like seeing someone thatlooks normal versus the really you know,
made up actress type people actually sellstuff because it's more believable to me.
And since since she created it,I think that's kind of cool. She
made it and she's advertising it,you know. Yeah, And I mean

(42:49):
and obviously they've done some research onthe on the demographics, uh huh.
And I don't know if you heardearlier that missus Riel had this, They
had the same conversation, and shehas a few points she she'd want to
see, like Blithe Dinner or halleBerry, you know, doing the total
body deoderant because no, no,no, no, no, no now

(43:13):
now now you're now no no nowyou're throwing Karen under the bus people flag
flag fig. No, I'm gonnatell you all right, I'd rather be
seeing halle Berry or Black Dinner.How about that. There, I'll die
on that sword. But I dounderstand that the the but but yes,
I understand your point, So payim the argue the argument. And it's

(43:34):
really not an argument that this hasbeen well established. Uh. The demographic
that they're appealing to is the slightlyoverweight males and females who have a glucose
diabetes problem. That's the demographic.So the the company that put the ad
together, with the approval, ofcourse of the manufacturer, decided that we're

(44:00):
going to go with real looking people. And I think that that's we're talking
about the diabetes medicine. Now,yes, I agree, Yeah, I
switch gears. Yeah, I'm talkingabout the diabetes ad with the fat people
that can't dance very well. Didn'twe say in the office on Thursday we

(44:20):
might not want to use the wordconversations. Well, wasn't that conversation to
me? The bad part is thatthey don't dance very well. That's the
bad part. How about short?How about no, it's careful, careful
okay, but but so so.But there are two schools of thought about
that. And and for for decades, for decades, advertisers were using certain

(44:46):
images and I get I get howthat might be, you know, problematic
or or or negative. And Idon't know what. I don't know what
the real answer is here. Who'sokay, who's buying the deodorant the woman
with the smelly feet or the husbandwho has to sleep next to the woman

(45:08):
with the smelly feet. Honey,I got you this stuff, okay,
not saying anything. You must havesome thoughts on this. I mean,
Ballard, we love when you talkabout your achilles and all your your injuries.

(45:30):
So that is this great stuff,so keep it up. Look,
your point, Pam is very welltaken. I absolutely get it. Yeah,
I get it. But I thinkI think, because you guys are
raising girls, the one thing youdon't want to do is to have them
feel like they always have to looklike these model people to be accepted or

(45:52):
to sell anything. Well, soyou guys should be at the forefront of
Hey, I love seeing all thesedifferent body types. This is great and
honey, you can do it toowell. You're right. Here's my question,
Pam, because we we talked aboutthe case and the clinic about the
fifteen year old right, no girl? Who? Yeah, what are your

(46:15):
thoughts on that? I mean,I've got a fifteen year old daughter,
I know, you know, whenI'm dealing with some of her injuries at
home. It does seem to bea challenge. Is this Is this a
generational thing? Is it A?And Pam? Is it a you're a
fifteen year old athlete at some point? Yes, I think there's just a
lot happening in that age. Gris. Yeah. I think the challenge is

(46:37):
that they don't feel safe enough toactually state the truth that I don't want
to play for this coach. Iunderstand. So they're coming up with me
because you know, the friends willbe like, what do you mean you
got to play? In all thepeer pressure, So they're trying to find
it out that will be accepted andstill keep them, you know, viewed
favorably by their friends, the coachand so forth, because they're afraid to

(47:00):
say, you know, this person'sa so and so, and I don't
want to play for them. AndI get it. The problem is we
have to treat them. I understand, so and I don't know how you
get to have a conversation with themwhere someone else is not around, or
at least a parent. I knowthey can be honest with you. That
is the trick. If there's away we can somehow get them to tell

(47:20):
the nurse or somebody you know well. And a lot of times you're not
going to get it even if they'reby themselves, because because you're right,
there are so many pressures on teenagegirls from every different direction. You do
a ten thousand dollars work up andturns out she didn't want to play for
that coach, and it is reallydifficult to treat. I thank you so

(47:40):
much for getting on the phone.Thank you. I appreciate the fleeing back.
We all love you, beg youto heart. All right, it's
great talking to y'all. Thank you. Soya. You're going to be a
regular, no problem. I'm herequick little break Inside Sports Medicine coming back
and I can makes good for aweekend. Welcome back, what Welcome back

(48:10):
to Inside Sports Medicine. Teo Soryout here live in the studio. So
we're not gonna leave teenage boys offthe hook on this one. So last
segment we're talking about how difficult itis for us to take care of teenage
girls because of the pressures that they'reunder U But teenage boys exactly the same.

(48:36):
We see I've seen them in everysport, you know, team sports,
individual sports like golfer, tennis.You were talking about picture, Yeah,
this is this, you know.It's when things are just aren't adding
up, right, Like you've we'veseen enough patience that when the interaction is
off, things aren't you know,adding up. We talked about this last

(48:59):
week, like we get these points, you know, with getting a history
from the patient, examining them andx rays and and when and when the
picture isn't clear, if it doesn'tfit, you must you must have quit.
Quit And so how many people madehis way made his way to on
this show. But and I rememberI had a I mean a phenom right

(49:22):
six y six lefty picture, sixteenyear old and just walking into the room,
I remember thinking, something's not thedynasty, the dynamic. There's an
interesting energy, right, Dad's answeringall the questions. Patients. They are
just lying flat on the table,very disinterested in terms of being here.
But it's like does your elbow hurt? Yeah, Dad's doing all the answers,

(49:45):
and you know, this kid endedup fizzling out and not really turning
into much. But the pressures ofperformance and the observation here, and we
were talking about it during the break, doctor Bloomenthal, Ballard, myself and
even Daniel and Hunter. When whenwe see a I'm probably gonna dig myself

(50:09):
into a hole here. When wesee a teenage girl, usually the girl
does all the talk. Uh.The dynamic between the girl and the mom,
uh mom kind of in the background. She does all the talk.
When we see a teenage boy,usually the dad's doing all the talk.
Rarely does a teenage boy come intothe office with his mom. It's almost

(50:30):
always with his dad, and thedynamic and the pressures are are different.
You know it. It is dadthat appears to be living his second life
through his kid. And and andagain this is that it's not lost to
see you. Was I doing thata little bit? A little bit?

(50:52):
I think you talked a little bitthat. Again, when when we have
a teenage girl, she does allthe talking. I mean rare, rarely,
And I've actually seen the girl turnto her mom, shut up,
Mom, look in front of me. I've seen that. I never had
my dad take me unto like that. It was always me and my mom,
so I always did the talking,or she'll just step in and be

(51:14):
like, Okay, you've had yourtime. Let me say it. It's
the opposite sex parent usually the interactiongoes better. Yeah. Well, so,
so I dislocated my shoulder when Iwas in high school, and so
my mom is when I took methe doctor. So I'm with you on
that. But and I'm not justI'm trying not to put everybody in the
same bucket. It's really different.It's really fun to generalize though, But

(51:37):
when you look at this from thirtythousand foot view, which is what we
talk about here on this show,the dynamic between the teenage girl and her
mom and the dynamic between the teenageboy and his dad are different dynamics.
Oh yeah, for sure, andthey're manifested when we're trying to fix a
problem, you know. So there'sstory that you gave about the picture and

(52:01):
dad did all the talking. Whowas that quarterback for USC This was twenty
years ago that his dad was feedinghim frozen chicken livers and never really he
was a draft pick. I thinkhe played for the Cowboys at one point
was I don't remember the chicken liverstory. I'll never forget that in my

(52:22):
life because the dad was feeding hisson frozen chicken livers because of the protein
or whatever. Somebody knows this,somebody knows who I'm talking about. But
you're talking about the parental pressure.Parental pressure feest man. Yeah, I
tell you, and it comes out, and like you said, and I
don't know. I don't think it'sintentional. I think some of it is

(52:44):
subconscious when it comes to the athletewhenever you're sitting there talking to him.
But at the end of the day, a lot of it is just they're
worn out. They don't for whateverreason, and they're saying this hurts and
it's not adding up. Yeah,I went this far, but I know
you can go further than I did. If it's the same sports, same
sex parent Yeah, and and andit's look, we get it, and

(53:07):
and sometimes that that is how youyou push. But the the risk is
you push too far. And notonly is that manifested in over use injuries,
which is what we see you know, hey, he pitched too much,
he threw too much, he rantoo much, but we also see
it in in burnout. Yeah,you know, never in my wildest imagination

(53:31):
that I think that as a sportsmedicine doctor, I'd have to be a
psychologist. Well, the trainers tothe trainers, the trainers and the physical
therapists. Have you ever had aconversation with a physical therapist that you're sending
your patient to or somebody that's goingto be taking care of them in the

(53:52):
rehabilitation process and you say, hey, just so you know, this patient
is going to need a little incurregiment. They are, they're gonna need,
you know, a little bit ofthis psychological kind of Hey, let's
let's let's get it moving, becauseyou know, without it, they're probably
not gonna do well. Sometimes takingcare of a case of tendonitis is a

(54:13):
lot more difficulty just inflammation in attendance. It becomes extraordinarily cumbersome. That's our
backstrain. Yeah, when when it'sjust a soft tissue injury and there's nothing
like objective, those are tough,particularly in the scenario of which you were
speaking. Remember, doctor Mooney,are our department chief. I can't see

(54:37):
pain? Yeah, that was Selby, by the way, it was doctor
Mooney. No, it was SelbyMooney. Doctor Shelby. He said,
I can't see pain, but mydog can smell it. That was the
line. I think you are dreaming. Well, we'll come back. I
don't know, but I don't tryingto verify that by other residents. Just
talk to the other residents of ourclass who said that. All right,

(54:58):
nothing that you would think. There'stwo surgeons having an argument that completely derailed
the segment. We are now completelyoff topic. One last thing that I
wanted to talk about, which wason my on my list, and since
we only have a few minutes left. Sometimes and Ballard and I were talking

(55:20):
about this yesterday in the office.Sometimes a certain injury or ailment, or
procedure for that matter, doesn't goas smoothly as we would like, for
sure, and yet the outcome turnsout to be fine. It's better to

(55:40):
be what lucky than it's better tobe lucky than good. Then that was
Vert Mooney. That was a VertMoody. It's better to be lucky than
good. You keep going back tothis. I'm sticking with Vert Moon is
the one that said I can't seepain. I don't understand why we're arguing
this anyway. I guess it's notmutually exclusive that they both could have said
that, but they were friends.So maybe maybe those cases keep me,

(56:04):
those cases you brought it. Weare now back to come back. So
you're talking about there are times whenit is completely mismanaged. Absolutely, I
mean, you know, you doyour best, but sometimes either the procedure
or the compliance or the compliance orthe patient right, but like things are
not optimal. Let's just put itthat way, from the either from the
treatment to the you know, diagnose, whatever the case may be, things

(56:28):
aren't optimal and the patient does fantastic, fantastic, Yeah, run as fast
as time. Ever, how isthat possible? Yes, we have you
know, we have this similar thingin spine where you know, we do
all these implants and because of theanatomy technique something like that, it's like
a little bit off. The littleX ray bugs the crap out of you.

(56:50):
How are you doing? I haveno pain on fantastic And then you'll
have ones where it's perfect, it'sperfect. You know, Hawka, I
still hurt doctor. You know whatI'm talking about. You know what we're
talking about, Like you do everythingright, everything was done. I mean
it's like I couldn't have done itany better than that, I know,
and everybody on the team couldn't havedone it any better, and they're like,

(57:12):
there's something still wrong. I know. And it's those cases that keep
me humble. I would tell youyesterday, I was like, that reminds
me somebody else is looking over me. Look, I'm telling you it truly
is better be lucky than good.But there's We've talked about it on this
show many many times, and oneof the biggest frustrations that I've always had
a hard time wrapping my head aroundis the uncertainty of medicine. Right.

(57:36):
You know, medicine is not perfect, and you tell people lay people that
they don't understand what what do youmean? Medicine is not perfect. It's
very scientific, You've got studies blahblah blah blah. Look, you can
there is certain procedures that has afive percent failure rate, yeap, And
that five percent is five percent nomatter how good a job you do.
Absolutely, and that's that's well whatit comes down to. It is,

(58:00):
and we've talked about this for decades. It's effective communication with patients. It's
that preoperative visit, that last visitis the one where you say you know
there is a five percent chance andin spine it's ten. Well, it's
lumbar's ten cervicles five where everything goesright, the implant's perfect, and you're
still gonna have some pain. AndI'm going to tell you that now because

(58:22):
if you have pain, I'm gonnaremind you that I told you that,
because I'm dictating this note in frontof you. Okay, So this is
my theory because we talked about thisbefore. We talk about randomized control trials
correct to really try to get themost objective science of what works. Here's
my theory. It is very hardto have purely randomized control trials because at

(58:45):
the end of the day, oneof the biggest influencers is the way the
doctor communicates with the patient, andso if you take that aspect out,
you're actually taking an aspect of theperson being able to do better. That's
just my thoughts. So it goesback to who are you seeing. It's

(59:06):
the reason why we're not a commodity. It's not reason why it's not cookie
Cutter's exactly, just because part ofthe reason why your outcomes are good,
doctor Bloomenthal, part of the reasonwhy your outcome is so good doctor soriet
is because there is an element ofyou and not just the procedure that actually
helps get the patient better. Ithought it's because I'm a better surgeon.

(59:28):
Well, I think it's everything,right, No, No, I think
it's everything. I do want tosay, I do want to say because
Brad you raised a really good point, and Scott, I do the exact
same thing. My preoperative visit isprobably the longest of all of our visits,
and I mean the longest of allof my visits. So if I
see patients ten times, the preoperativevisit is the longest of all of them

(59:50):
because that's when you manage expectations.That's when you tell them that there is
a five percent failure rate. That'swhen you tell them that if everything goes
absolutely perfectly, you may still havesome aches and pains. So to me,
the communication is exactly what is neededin our world. And Brad,

(01:00:12):
you're right, it is our abilityto communicate that helps make a good doctor
from an average doctor. And unfortunately, unfortunately, with the way economics of
medicine is, we don't have thetime. Now at Texas Sports Medicine and
at Center for disc Replacements, wedo have the time because there are different
practices. We do have the timeto sit as our style is different at

(01:00:37):
our practices. But in the inthe factory type of orthopedic practices, they're
being seen by the MA or thePA or whatever whatever, and the doctor
stix is head in a room forthirty five seconds or you're seeing forty patients
in it half a day. Yeah, you're seeing forty patients in a half
a day. Right, So,unfortunately, because of the economic the medical

(01:01:01):
economic climate, you don't have thetime to spend with the patient. Well,
no, not in my practice.At our practice, we still my
pre op visit was done near anhour, isn't it about five five minutes
at least. I've seen more secondopinions, not because somebody did something technically
wrong, but because patients said Ididn't feel comfortable, I didn't hear anything.

(01:01:22):
I had to say, Yeah,that's the that's oftentimes the more second
opinions that I see. Yeah.So, but but the uncertainty of medicine.
Let's circle back to that, theuncertainty of medicine. We had a
what brought this on was a casewhere a youngster dislocated his elbow playing football.

(01:01:43):
It was witnessed. Doctor Leevy putit back in the joint, and
normally for dislocated elbow, in orderfor that to happen, all the structures
have to be damaged. All thisso an MRI was obtained. Pretty much
every structure was damaged. The MRIlooked like a bomb went off in the
elbow anyway, So he goes somewhereelse and basically comes back playing within like

(01:02:12):
ten days or two weeks with asleeve on his elbow, which is completely
completely mismanaged based on what we've knownfrom the Yeah, yeah, typically that
youngster would be in a brace forthree to six weeks until the structures scarred
down, et cetera, et cetera. But this is a case where it
was completely mismanaged. And guess whathe got away with it. He was
able to finish out the season.He was able to again the uncertainty of

(01:02:36):
medicine. The uncertainty of medicine.Sometimes the case can be completely botched and
it comes out great. Yes,yeah, well, it's the remarkable ability
of the human body to hear itis. It is because thick about all
the hundreds of years of you know, hunters having injuries falling off their buffaloes

(01:02:59):
or whatever and having terrible injuries andthey get better and that person not get
unlucky again and fall on that elbowmaking it around. Yeah, and that's
the thing. Coming back at tendays with minimum protection. It was a
huge risk. That's scary, hugerisk that could have very easily come back
again. That music in the backgroundmeans that we are about out. Hopefully

(01:03:28):
you enjoyed this episode and we did. We did and learned something new.
Separation, subluxation, teenage boys,teenage girls, look halle Berry, halle
Berry. Feel free that you seeus at Texas Sports Medicine or Center for
disc Replacement. I want to thankour sponsors Jaguar, Landrover of Dallas,

(01:03:52):
part of the Snow Automotive family.Also Backendorf Jeweler since nineteen forty eight and
TSM Performance and Recovery Center in SnyderPlaza until next week. You can reach
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(01:04:15):
us here on ninety seven one theFreak and our crew until next week.
Tell your friends, remember