October 29, 2025 • 28 mins
Dr. Sandeep Rao brings the borderland the latest information in healthcare, medicine and technology. He considers himself a hacker in the positive sense, using his intimate knowledge of the medical system to break down some of the barriers to accessing new medical technologies and information.
For more information call Dr. Rao's office at 915-500-4370 or email Rao@medicalhackers.com
Be the first to hear the show in News Radio KTSM-AM Saturdays at noon, an iHeart station.
For more information call Dr. Rao's office at 915-500-4370 or email Rao@medicalhackers.com
Be the first to hear the show in News Radio KTSM-AM Saturdays at noon, an iHeart station.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Good afternoons, you know, the weekend.
Speaker 2 (00:10):
Here in the heart of the dusty wall and desert
in West Texas. You're listening to the Medical Whackers. However,
you may be tuned in this week and I'm your host,
doctor Sandy Brow. I'm here to bring the borderline the
latest information in healthcare, medicine, and technology on the show.
I consider myself a hacker, a hack in the positive sense,
a hacker using my intimate knowledge of the medical system
(00:30):
to breaking down some of the bearers to accessing new
medical technologies and current healthcare information. So I'm here in
studio with my producer, Amber is here with me. So Amber,
I wanted to go through some questions that I frequently
get from patients who asked me about how to avoid
(00:53):
worsening the damage to their knees. And I think this
kind of fits right up your alley because you're a
big exercise buff. You know all the different types of exercises.
I learned something from you. You'll always you'll show me something.
I'll be like, wow, I need to I should incorporate
that into my regimen. And I have incorporated a little
bit if I once I find time right. The biggest
issue for me is time, I think, and that's the
(01:14):
biggest issue for anybody out there.
Speaker 1 (01:16):
Right you have.
Speaker 2 (01:17):
Your normal work and then you have to sort of say,
I'm going to make sure I do something that may
not necessarily maybe it does benefit you that same day,
but more likely you're looking for something that's going to
benefit you down the line. And that's that's a little
difficult with that the if you're not getting that immediacy
of that benefit. But there are definite benefits to exercise
(01:39):
immediately relate to sort of endorphin release, which I'll kind
of get into. But the reason I wanted to do
this is that I get a lot of patients who
come in they have chronic knee pain, and as you know,
I offer a lot of different treatments for patients who
are trying to avoid new replacements. Now, what is that
INTI of In the past, I've discussed this. It's everything
(02:02):
from just a joint injection with with a like a
corn zone shot, a steroid shot. We may be mixed
with some a numbing agent like aliva cane, but again
that's sort of a short term fix. Then we have
folks at the very very end have already been deemed
to be a candidate for a new replacement, and I
(02:23):
of course don't offer knee replacements. I'm trying to give
people options to avoid near replacements. So there's a minimillion
invasive treatments that I do where I go in through
a little IV and I deliver right in the knee
joint medication to decrease the inflammation around the knee procedure
that to call it genicular ardymbalization.
Speaker 1 (02:43):
Then there's other.
Speaker 2 (02:44):
Stuff that I do related to nerve stimulation called peripher
nerve stimulation. But really folks often ask me all these
things apart from a new replacement, how is that going
to affect my knee joint? Because you're not changing the
actual bony structure. So whenever you have arthritis in your knee,
over time, what has happened is your bone starts to
(03:08):
deteriorate and it starts to create little bone spurs, and
sometimes there's thinning of that knee joint because the cartilage
that's surrounding that knee joint is wearing away.
Speaker 1 (03:21):
It could have been due to multiple reasons.
Speaker 2 (03:23):
Maybe some folks have just carried a lot of weight
over the years and that that impact on that has
torn away at that carlage. Maybe you've had an injury,
maybe you had a you fell down, maybe you had
an accident, Maybe you're playing football, maybe you're a powerlifter,
maybe you're doing any of those things, and that's causing
(03:45):
that's caused damage to the shock absorbers of your knee
penal eraser.
Speaker 3 (03:52):
When you keep erasing and keep erasing, it just dwindles down.
Speaker 2 (03:55):
Exactly, and it's difficult for to just magically regrow, and
so over time you're just really at the very end stages.
It's very difficult to get rid of that damage that's happened.
And so that's why some folks have to resort to
a new replacement. But some of the proceders that I
offer is designed to avoid it, and I do offer
it for patients who maybe you're considering a new replacement,
(04:18):
but they want to buy more time. If you remember,
new replacements sometimes might have a certain shelf life. Maybe
it's fifteen years, maybe it's ten years, because the hardware
that they put in when you do a new replacement,
or I don't know how familiar you are when your.
Speaker 3 (04:30):
I was going to ask you what exactly are they replacing?
What does that look like sure?
Speaker 2 (04:33):
So actually, you know, I actually got a pretty good
look at this because initially before even going into this
field of doing interventional radiology, of doing minimally based procedures,
I actually did about a year or so where I
was doing a lot.
Speaker 1 (04:46):
Of as a was my surgical internear.
Speaker 2 (04:49):
I did a lot of rotations on orthopedic services because
that was actually my first true level. Was initially interested
in focusing on doing the big joint replacements, doing BID
and so I would frequently see and scrub in on
these cases. You know, it involves a big incision. This
obviously with surgery, they do us an incision right over
the knee joint and you have to take apart, take
(05:12):
you know, cut back some of that bone that's in
your knee joint.
Speaker 1 (05:15):
So you're using a lot of hammers.
Speaker 2 (05:17):
They're using almost like a you know, a chisel's almost
like trying to break into it.
Speaker 1 (05:22):
You're trying to take out some of that bone.
Speaker 2 (05:24):
They do what's called an osteotomy, which means they take
away some of it, just meaning removing that bone, and
then they have to replace it with a metal component
and put some cement into it to recreate a new
knee joint. Now, the technology has evolved since since once
I started doing this standard.
Speaker 1 (05:41):
Twenty years ago.
Speaker 2 (05:42):
Now you have a lot of minimum you have sort
of partial knee replacements and other things like that. But regardless,
the point is that these are all surgeries, and I'm
a big believer that if you can avoid a big
surgery with some other alternative, it's usually best to do
it until you really really need the aknee replacement, until
you're at the end stage when it's.
Speaker 1 (06:03):
Really no other option.
Speaker 3 (06:04):
Yeah.
Speaker 2 (06:05):
But folks who come to me for these minimally invasive procedures,
these injections, these where I go through the IVY, where
I do a nerve stimulation, they say, what is though,
what is going to be the long term impact on
my knee joint? Because what you are doing, what I
am doing during these procedures is I'm basically I am
masking the arthritis, I am covering up the inflammation that's
(06:29):
going there, or I'm distracting the patient from believing that
there's pain. When I do a nerve stimulation procedure, there's
pain signals that travel on these nerves, and what I'm
doing is I'm bumping that pain signal off and giving
that nerve a different signal, generating a different little signal.
So then your body is only recognizing this alternate signal
(06:52):
on your nerve, it's not recognizing pain, if that makes sense.
Speaker 3 (06:56):
So can I so say there is something that the
patient has been doing years, maybe they're walking wrong or
whatever that's making that knee pain happen, and you're doing
these procedures that, like you said, distracts or they can't
feel the pain, they don't notice it. They could still
be doing that thing that's making the knee worse exactly.
Speaker 2 (07:15):
And so that's why folks often ask me what is
the life expectancy so to speak, or how much benefit
in duration can I get from my procedure? And so
I tell people that the goal with our procedures is
to get your relief from anywhere from on the short
end three years to maybe even up to ten years.
Because remember, if I have now given you the ability
(07:37):
to now walk on your knee, to be able to
go back to all your activities, to be able to
now go swimming, go bike and go hiking, go playing
with your grandkids, the fact that I'm now masking that pain,
but you're still wearing out your knee joint. That does
mean that your knee will still continue to deteriorate.
Speaker 3 (07:55):
So would it be a good thing to also do,
like maybe some kind of physical therapy along with the
person that you're doing exactly.
Speaker 2 (08:02):
So that's exactly you've kind of teed it up for me,
because this is exactly the thrust of what I wanted
to talk on this show because a lot of patients
asked me, so what can I do? What should I
do to minimize that long term damage? Because by coming
to me, I've now made them pain free, or maybe
not pain free totally, because some folks say, you know what,
(08:23):
I am at ten out of ten knee pain, but
maybe now I've gotten them down to four out of
ten or two out of ten, so you're still going
to have a little bit of pain. It's very difficult
for me to wave a magic wand and say I'm
going to make you completely pain free and you're like
a twenty year old, but you're still going to have
maybe a little bit of pain. It's almost like imagine
(08:43):
you have a light bulb and you have a dimmer switch,
and so I'm now dimming it, but I'm not completely
turning it off. But I'm now giving you enough pain
relief to where you can go back to your activities. Now,
what's the downside? Just what you mentioned, you could potentially
make your knee joint worse. And that's exactly where I'm
going to go with this next segment, which is what
are these sort of exercises and physical therapies that are
(09:06):
recommended and identified as the best options for folks out there.
Speaker 3 (09:12):
To back your view, you're listening to the Medical Hackers
with doctor Sandeep Rau, board certified vascular interventionalist bringing you
insights on treatments for common medical problems on news Radio
six ninety KTSM. For more information on the issues being discussed,
or to contact doctor Rao call nine one five five
zero zero four three seven zero or by emailing Rao
(09:33):
at medical hackers dot com.
Speaker 2 (09:36):
Background The Hackers, Doctor out Here and Jury to Break
Ambers cooled me on different types of lunges, which is
which I think is a good intro into getting into
what we do for folks who have arthritis and the
exercises that are recommended. So first off, it's important to
know when it comes to ne arthritis, not all exercises
(09:56):
are equal. So there's a lot of different types of
exercises that that are recommended bydocs. One is something like
an aerobic exercise where you're kind of maybe just kind
of doing constant motion, maybe cycling, you know, biking, maybe swimming.
To a certain degree, folks include for you walking and
(10:18):
i'd be considered a true aerobic exercise.
Speaker 1 (10:20):
More and more probably more running.
Speaker 2 (10:22):
But when you're talking about folks who are carrying a
lot of weight having difficulty moving, you know, we include
walking in that same category. There.
Speaker 3 (10:29):
Walking is definitely underrated.
Speaker 2 (10:31):
Yes, Now there's other types of exercises that are also
identified what we call, you know, neuromotor exercises. These are
exercises that folks do where you have to involve balance
and coordination. Now, what is a good example that something
(10:51):
that like dance? Yeah, you're right, you know, so that
in something if you are you know, you're if you're
going out and you're dancing, you're obviously enjoying your self,
but you're also we have to kind of be a
little bit coordinated. If you hopefully you look coordinated on
the dance floor, but you know, especially if you're doing
like something like maybe a partner dance or something. You
have to be you have to really be able to know, oh,
(11:11):
I'm making this step and going forward or going backwards
at the right time.
Speaker 3 (11:16):
And I think people have to be careful with dancing
because they think, oh, I'll go take a dance class
at the gym. And then there's a bunch of like
jump lunges, which are jump squats, which they probably shouldn't
be doing less they know how to do a proper squad.
Speaker 2 (11:26):
Oh absolutely, Oh I've done jump squats. It's been a
while since I've have to do a jump squad.
Speaker 3 (11:30):
They're horrible.
Speaker 1 (11:31):
That was almost to me.
Speaker 2 (11:31):
A jump squat has got an X. It's got a
component of aerobic activity to it because you're constantly it's
almost like you're running, but you're doing it from a
squat position.
Speaker 1 (11:39):
So but but anyway, digressor.
Speaker 2 (11:43):
So when it comes to aerobic activities and these other
this other category which called neuromotor exercises, and some folks
also talk about mind body connection activities. So an example
that might be yoga or high chi. So there's actually
a study here that was done by the British Medical Journal.
(12:05):
So they looked at a bunch of these different exercises
that were prescribed to patients. They looked at two hundred
and seventeen different trials that were out there, and they
looked at how they all compared. Now, But what do
you think was the best thing if you have ne arthritis?
Obviously you're not a doc, although hopefully I've given you
(12:26):
good information over over these years. But if you had
to think, you know you have, if you had some
old patient came in and said, I'm dealing with a
lot of knee pain, would you would you recommend?
Speaker 1 (12:38):
What do you think is going to be the.
Speaker 2 (12:40):
Best for their short term gains maybe long term gains.
Do you think it's gonna be the aerobic exercises. Do
you think it's going to be something like these mind
body things that I mentioned, like a yoga, like a
tai chi. Do you think it's going to be a
recommending something like dance? What do you think?
Speaker 3 (12:54):
Well, I've actually had you know, I have a background
in personal training. I've had older clients with issues like that,
and what I would probably do is body weight bandit exercises,
you know, put the band around the knees, body weight stuff. Honestly,
some type of resistance training. No cardio, yet no group
classes that would be my recommendation body weight and bands.
Speaker 2 (13:15):
Okay, so that's definitely you know, that's within the realm
of what they recommended. But I'll just tell you. So,
so what they found is with this two hundred and
seventeen trials that they did, and this was our studied
PERO done from nineteen ninety to twenty twenty four, so
it's almost over a thirty five year period of time.
Fifteen thousand participants were in this overall these different studies,
(13:37):
and they looked at time points about four weeks after
starting training, twelve weeks and twenty four weeks, Okay, so
they kind of divide into short term, medium for lng term.
And so what they found was that when it came
to short term pain, aerobic exercise was the most superior
form of treatment. So what do they mean by aerobic exercise?
So they recommended things like swimming, cycling beyond a little
(14:01):
cycling bikes like one of those maybe stationary bikes. Yeah,
And then they found second was what we call mind
body exercises, so stuff like something like yoga, which also
includes you know, forms of stretching as also is within
that cat.
Speaker 3 (14:17):
Doctor if I can interrupt the aerobic exercise. Though they
mean more low impact, right, I wouldn't they meant like,
you know, no cheeses and running and springs, no jump squads,
you know, not the combat bike, but the course.
Speaker 1 (14:28):
Right of course.
Speaker 2 (14:28):
So that's why when I said Arabic, I know, Arabic
means different things for different people.
Speaker 1 (14:32):
You as with your training background.
Speaker 2 (14:34):
If you're recommending, you may not think initially, oh, let's
just put it do a little bit of you know, swimming,
that may be very very low impact, right, And honestly
that's what you need when you have this much damage
that's already occurred to your knee joint. And so now
what they did find is that, you know, Arabic Exercis's
head saw the most improvement with gate performance. So in
(14:56):
terms of the way you walk, they found the most
improvement there at twelve weeks. But then when they started
looking at sort of even long term improvement, they actually
found folks who do these neuromotor exercises which addressed like
you know, postural control sensation like dancing, any sort of
coordinate activity, actually had really good impact from a long
(15:17):
term perspective as well. So but overall, the aerobic activity
just overall blew away the entire competition when you look
at that short term quality of life improvement. So when
you started looking at four weeks doing some of that,
you know that just constant motion, like slow, low, you know,
low level impact motion was the one that was most affected.
(15:40):
Now you might wonder why why would this type of
an activity be helpful, So when you started looking at
things like walking, cycling, swimming, as you said, it has
sort of less impact on the knee as opposed to running,
where you're running strong linder, whether it's a treadmill or
whether you decide to go run around.
Speaker 3 (15:59):
The lock and jump pound have good running dynamics for sure.
Speaker 2 (16:05):
Now, what that does is that actually stimulates the production
of a fluid in your joint space called the synovial fluid.
So you might think of that as like, you know,
like a little bit of oil for the rusty hinges
in your knee. So that's what any of these activities
helps stimulate it. And you want to stimulate the production
(16:25):
of this synovial fluid because it really helps lubricate that joint. Now,
the other thing it does is by hydrating that joint,
it helps prevent further wearing out of that carlage. So
your you know, your bone is there, it's colored with cartilage,
and your carlage is probably already worn out a bit
if you have arthritis. And so by hydrating a little
(16:46):
bit with this synovial fluid, this joint fluid, by stimulating it,
that should help further prevent ongoing damage. Now, some folks
get gel injections. Some folks call it, you know, classically
rooster comb injections because in the past they actually got
a lot of this gel. It was extracted from from
(17:08):
the from a rooster. But that people folks classically call
it rooster comb injections, although we don't really use that
as sort of an old school term for it. But
gel injections is something that also is designed to to
sort of simulate that synovial fluid that's released in your joint.
But as I said, so, what's one of the things
that folks wonder about is what about the immediate impact,
(17:30):
Like is there anything that by doing these activities that
does it help me immediately? And that's where you know,
endorphin release. Whenever you're running, it's almost endorphins are sort
of released by your body, and it's sort of boy,
your body's natural painkiller, and so that can always help
you out just by getting up moving. And so when
(17:50):
patients come and ask me, I tell them I think
it's good to have some low degree of movement. But
if someone's telling me I can only really do some stretchingercises,
that's not gonna hurt. But there's other stuff that's better
out there. So it's in general, it's always good to move.
And so I think, you know, when we look at it,
so walking overall is just not as good compared to
(18:13):
cycling or swimming, just because there's a little bit more
impact loading on that knee joint. But I don't want
folks to, you know, listen to this and go, I
don't have access to a swimming pool, I don't have
access to a bike, and then not do any exercise.
So I don't dissuade anybody, but I just kind of
tell them, you know, these are sort of what's available
out there, and it's it's good to do weight bearing
(18:37):
exercises in general, though as you get older, because that's
as you know, as a as a strength training, you
know that it's good to be able to maintain that
muscle that you need, because another component of that knee
health is not just keeping that joint well lubricated, but
also strengthening those muscles. The quarter step, the same exercise
(18:58):
we were doing during the break where you're showing me.
Speaker 1 (19:00):
How to do a proper lunge.
Speaker 2 (19:03):
You know, it is good to have that quad step
muscle which is on the top of your knee, have
it nice and strengthened, because that's going to be a
significant significant impact on overall lowering the impact on your
knee joint.
Speaker 1 (19:15):
So I'm gonna take a quick break.
Speaker 2 (19:16):
Here and talk a little bit further about a common
question that I get as well.
Speaker 3 (19:23):
You're listening to the Medical Hackers with doctor Sandeep Rau,
board certified, a vascular interventionalist, bringing you insights on treatments
for common medical problems on news radio six ninety KTSM.
For more information on the issues being discussed, or to
contact doctor Rao, call nine one five five zero zero
four three seven zero or by emailing Rao at medical
hackers dot com.
Speaker 1 (19:45):
Soy Amberg, have you ever heard a patient say.
Speaker 2 (19:49):
Maybe they could they could sense that a storm was coming,
or maybe they feel like they feel like the temperature
is gonna draw.
Speaker 3 (19:58):
Because their knee starts hurting. They're like, storm's coming.
Speaker 2 (20:01):
I'm like, okay, yeah, so that's it's definitely a weird
sort of a question because I actually had a patient
yesterday who to ask me. And I've had this question
asked to me multiple times from different patients, and they'll say,
I've noticed that the temperature is changing, it's getting a
little cooler. Why do I feel or maybe it's raining
(20:21):
a little bit more. Why do I feel like my
joint pain is flaring up?
Speaker 3 (20:27):
Yeah?
Speaker 2 (20:28):
Well, I'll first cut to the chase. So there's no
significant scientific data that is connected x, like you know,
a temperature change drop or a change in the barometric
pressure outside and shown exactly why that has led to
a change in joint dysfunction enjoint pain.
Speaker 1 (20:49):
So that's the bottom line.
Speaker 2 (20:51):
However, I want to kind of get into this because
there are a lot of theories, because I see this
question raised often enough that sometimes you don't need to
have scientific data to think you want maybe there is
something there where a lot of patients are asking me
about the exact same question, the exact same complaint, and
I want to kind of get into this a little
bit more. So, what are some theories about why weather
(21:13):
confect your joints? So one thing is that it is
now getting a little bit cooler. So cold temperatures can
cause your blood vessels in generally any part of your body,
it caused it to constrict, meaning it caused it to contract.
So it gets it to cause it to get smaller,
because what it does is it reduces your blood flow.
So if you think about it, imagine if you put
(21:35):
your hand, your hand in icy cold water, what's going
to happen is all those blood vessels in your hand
are going to shrink down.
Speaker 1 (21:45):
Now why does your body do that?
Speaker 2 (21:47):
Because the blood system is sort of a conduit to
where any sort of a connect, your connection to the
outside world. So if you get a lot of cold
from the outside, your body wants to maintain its core
temperature of warmth. And so if there's a lot of
blood flow going through your hand, and now that blood
(22:07):
flow is being exposed to all this cold, now you're
gonna now make your whole body cold. Does that make sense?
But now by making by your body naturally constricting or
contracting those blood vessels, now less blood is going to
go to that hand, So now there's less blood exposed
to the area where there's cold. So that way, it's
almost like imagine like I don't know if it's a Honestly,
(22:30):
I don't have a good example. I was thinking about
ice cubes, but that's not a good example because ice
cubes obviously they dissipate, they melt, they melt, right, But
if you think about it, you know when you have anything,
that your blood is the way you are exposed to
your environment. And so when you have a lot of
blood flow in an area where there's a lot of cold,
(22:51):
you don't want as much blood flow there. You want
to have less blood flow because you want to maintain
your your good normal body temperature. So just that overall concept,
whether you have knee pain or not. When you have
knee pain, the same blood vessels in your knee joint
theoretically constrict, they get smaller, they reduce your blood flow
(23:12):
to that knee joint, and so folks think that that
increases the stiffness in your knee joint when the temperature drops. Again,
this is a theory, right, they haven't done scientific tests
to say, you know, done one hundred different patients and
figured this out. But this is a theory about why,
one theory about why cold temperatures can cause increased stiffness
(23:35):
with arthriaves.
Speaker 3 (23:35):
Can I give you a theory?
Speaker 1 (23:36):
Sure?
Speaker 3 (23:38):
Well, didn't you say that some of the new replacements
there's like steel in there. Yes, wouldn't the steel get
cold if it's colder?
Speaker 1 (23:43):
Oh for sure.
Speaker 2 (23:44):
But I'm actually talking not just about patients who've had
knee replacements. I'm talking about actually the vast majority of
patients who come to see me.
Speaker 3 (23:50):
Pain without a replacement.
Speaker 1 (23:52):
Oh of course, exactly.
Speaker 2 (23:53):
Oh so I do have a bunch of patients who
have not had any knee replacements. They just have underlying arthritis.
And they will tell me, you know what it was.
It started raining this past week and the weather has
been getting cooler, and now I'm feeling more joint pain.
They have not had any surgeries, and they asked me
about this. Another thing is that what about the changes
in the outdoor pressure. So it's changing the barometric pressure,
(24:16):
and so if there's some storm system coming in changing
that pressure, that that can theoretically expand or contract your
tissues around your joint again leading to joint leading to pain. Now,
another thing is that humidity. So some folks think that
when you have high humidity. We don't get that, thankfully
high humidity in West Texas like you get it sort
(24:36):
of an East taxes. But that can increase the moisture
in your joint, just high humidity, and that can make
inflammation and pain worse by having more moisture in your joint. Again,
I don't really understand that concept. This is just a theory, right,
but people.
Speaker 3 (24:56):
That it's worth investigating.
Speaker 2 (24:58):
And so, so what about you know, so when folks
have so what we have seen in general is when
folks have arthritis and it's really cold. To me, when
it's really cold, you don't want to go outside, so
you're probably stuck in bed. And the more you're inactive.
To me, that corresponds with you are not your inactive,
Your joints aren't moving. As I said, by moving, by swimming,
(25:19):
you're creating more snovia fluid by that helps lubricate that joint.
So that's my thought is that you know, you have
patients with arthritis have more pain because it's cold. You're
not moving now too, Folks with the rheumatoid arthritis, which
is not arthritis, is the vast majority of patients. We
see the vast majority of patients of arth threats. But
there's this condition called rheumatoid arthritis, which is I don't
want to get into it, but it's a we call
(25:42):
it an autoimmune inflammatory condition, which is also known to
be worsened by weather changes. And they found that cold
temperatures and humidity can't trigger flare ups.
Speaker 3 (25:52):
What about issues with you know, patients that go in
and maybe they have knee pain on one side and
they get the surgery. I know, like there's some people
that are worried about maybe the other leg being affected
because it's going to have to compensate. Yes, Like, do
you have patients that go in up with that?
Speaker 1 (26:07):
So I have patients who come in.
Speaker 2 (26:08):
They'll come in with pain in both knees, but they'll say,
you know what, my pain on my right knee is
eight or nine out of ten. My pain in my
left knee is about two or three out of ten.
But it's slowly creeping up. And when we do the
x rays, we find out that one side that maybe
that right knee which had nine out of ten pain,
has worse our stritus. The other knee has a little
(26:31):
bit less but it's creeping up. So they ask me
which one should I treat first, what should I do?
And so usually when I do these treatments, where I
go in, put this medication in, and I'm able to
get rid of their pain in that the really bad
knee in this case, this example, the routney which has
worse arthritis, worse pain. They'll tell me after the procedure,
(26:51):
not only do I feel better on my rotney, but
my left knee is also starting to feel better.
Speaker 3 (26:57):
Now.
Speaker 1 (26:58):
The reason for that is the.
Speaker 2 (26:59):
Thought is that you know you have been affecting the gait,
You've been changing the way you walk to compensate for
this knee pain. You may have eve been putting a
lot more pressure on your good or better knee, your
left knee. And so by me taking the pain the
pressure off that knee by making your worse knee better,
your right knee better in this case, now there's less
(27:21):
pressure on that other knee. So now I've now magically
not just treated your one nee, but I now also
helped you with your other knee. So that's something I've
noticed many often, and so in that case I don't
really try to treat their leftknee. But I'll say, you
know what, if you want, we can go after it.
It's not a big deal, but it is something to
(27:42):
think about. But that was a great question, and unfortunately
our time the Saturday's up.
Speaker 1 (27:46):
If you aren't interested in any more.
Speaker 2 (27:47):
Information on any of the mentioned minimum invasive treatments, you
can always call to get more information at none one
five five hundred forty three seventy that's five zero zero
four to three seven zero. You don't so reaching me
about email at raw that's my last name, r AO
at medicalhackers dot com. I hope these healthcare hackers have
(28:09):
helped you navigate our complex medical system. If you've been
tuned into us this whole time, bless your heart and
your health. I'm doctor Sandy Brow, and you've been listening
to the medical hackers
Good afternoons, you know, the weekend.
Speaker 2 (00:10):
Here in the heart of the dusty wall and desert
in West Texas. You're listening to the Medical Whackers. However,
you may be tuned in this week and I'm your host,
doctor Sandy Brow. I'm here to bring the borderline the
latest information in healthcare, medicine, and technology on the show.
I consider myself a hacker, a hack in the positive sense,
a hacker using my intimate knowledge of the medical system
(00:30):
to breaking down some of the bearers to accessing new
medical technologies and current healthcare information. So I'm here in
studio with my producer, Amber is here with me. So Amber,
I wanted to go through some questions that I frequently
get from patients who asked me about how to avoid
(00:53):
worsening the damage to their knees. And I think this
kind of fits right up your alley because you're a
big exercise buff. You know all the different types of exercises.
I learned something from you. You'll always you'll show me something.
I'll be like, wow, I need to I should incorporate
that into my regimen. And I have incorporated a little
bit if I once I find time right. The biggest
issue for me is time, I think, and that's the
(01:14):
biggest issue for anybody out there.
Speaker 1 (01:16):
Right you have.
Speaker 2 (01:17):
Your normal work and then you have to sort of say,
I'm going to make sure I do something that may
not necessarily maybe it does benefit you that same day,
but more likely you're looking for something that's going to
benefit you down the line. And that's that's a little
difficult with that the if you're not getting that immediacy
of that benefit. But there are definite benefits to exercise
(01:39):
immediately relate to sort of endorphin release, which I'll kind
of get into. But the reason I wanted to do
this is that I get a lot of patients who
come in they have chronic knee pain, and as you know,
I offer a lot of different treatments for patients who
are trying to avoid new replacements. Now, what is that
INTI of In the past, I've discussed this. It's everything
(02:02):
from just a joint injection with with a like a
corn zone shot, a steroid shot. We may be mixed
with some a numbing agent like aliva cane, but again
that's sort of a short term fix. Then we have
folks at the very very end have already been deemed
to be a candidate for a new replacement, and I
(02:23):
of course don't offer knee replacements. I'm trying to give
people options to avoid near replacements. So there's a minimillion
invasive treatments that I do where I go in through
a little IV and I deliver right in the knee
joint medication to decrease the inflammation around the knee procedure
that to call it genicular ardymbalization.
Speaker 1 (02:43):
Then there's other.
Speaker 2 (02:44):
Stuff that I do related to nerve stimulation called peripher
nerve stimulation. But really folks often ask me all these
things apart from a new replacement, how is that going
to affect my knee joint? Because you're not changing the
actual bony structure. So whenever you have arthritis in your knee,
over time, what has happened is your bone starts to
(03:08):
deteriorate and it starts to create little bone spurs, and
sometimes there's thinning of that knee joint because the cartilage
that's surrounding that knee joint is wearing away.
Speaker 1 (03:21):
It could have been due to multiple reasons.
Speaker 2 (03:23):
Maybe some folks have just carried a lot of weight
over the years and that that impact on that has
torn away at that carlage. Maybe you've had an injury,
maybe you had a you fell down, maybe you had
an accident, Maybe you're playing football, maybe you're a powerlifter,
maybe you're doing any of those things, and that's causing
(03:45):
that's caused damage to the shock absorbers of your knee
penal eraser.
Speaker 3 (03:52):
When you keep erasing and keep erasing, it just dwindles down.
Speaker 2 (03:55):
Exactly, and it's difficult for to just magically regrow, and
so over time you're just really at the very end stages.
It's very difficult to get rid of that damage that's happened.
And so that's why some folks have to resort to
a new replacement. But some of the proceders that I
offer is designed to avoid it, and I do offer
it for patients who maybe you're considering a new replacement,
(04:18):
but they want to buy more time. If you remember,
new replacements sometimes might have a certain shelf life. Maybe
it's fifteen years, maybe it's ten years, because the hardware
that they put in when you do a new replacement,
or I don't know how familiar you are when your.
Speaker 3 (04:30):
I was going to ask you what exactly are they replacing?
What does that look like sure?
Speaker 2 (04:33):
So actually, you know, I actually got a pretty good
look at this because initially before even going into this
field of doing interventional radiology, of doing minimally based procedures,
I actually did about a year or so where I
was doing a lot.
Speaker 1 (04:46):
Of as a was my surgical internear.
Speaker 2 (04:49):
I did a lot of rotations on orthopedic services because
that was actually my first true level. Was initially interested
in focusing on doing the big joint replacements, doing BID
and so I would frequently see and scrub in on
these cases. You know, it involves a big incision. This
obviously with surgery, they do us an incision right over
the knee joint and you have to take apart, take
(05:12):
you know, cut back some of that bone that's in
your knee joint.
Speaker 1 (05:15):
So you're using a lot of hammers.
Speaker 2 (05:17):
They're using almost like a you know, a chisel's almost
like trying to break into it.
Speaker 1 (05:22):
You're trying to take out some of that bone.
Speaker 2 (05:24):
They do what's called an osteotomy, which means they take
away some of it, just meaning removing that bone, and
then they have to replace it with a metal component
and put some cement into it to recreate a new
knee joint. Now, the technology has evolved since since once
I started doing this standard.
Speaker 1 (05:41):
Twenty years ago.
Speaker 2 (05:42):
Now you have a lot of minimum you have sort
of partial knee replacements and other things like that. But regardless,
the point is that these are all surgeries, and I'm
a big believer that if you can avoid a big
surgery with some other alternative, it's usually best to do
it until you really really need the aknee replacement, until
you're at the end stage when it's.
Speaker 1 (06:03):
Really no other option.
Speaker 3 (06:04):
Yeah.
Speaker 2 (06:05):
But folks who come to me for these minimally invasive procedures,
these injections, these where I go through the IVY, where
I do a nerve stimulation, they say, what is though,
what is going to be the long term impact on
my knee joint? Because what you are doing, what I
am doing during these procedures is I'm basically I am
masking the arthritis, I am covering up the inflammation that's
(06:29):
going there, or I'm distracting the patient from believing that
there's pain. When I do a nerve stimulation procedure, there's
pain signals that travel on these nerves, and what I'm
doing is I'm bumping that pain signal off and giving
that nerve a different signal, generating a different little signal.
So then your body is only recognizing this alternate signal
(06:52):
on your nerve, it's not recognizing pain, if that makes sense.
Speaker 3 (06:56):
So can I so say there is something that the
patient has been doing years, maybe they're walking wrong or
whatever that's making that knee pain happen, and you're doing
these procedures that, like you said, distracts or they can't
feel the pain, they don't notice it. They could still
be doing that thing that's making the knee worse exactly.
Speaker 2 (07:15):
And so that's why folks often ask me what is
the life expectancy so to speak, or how much benefit
in duration can I get from my procedure? And so
I tell people that the goal with our procedures is
to get your relief from anywhere from on the short
end three years to maybe even up to ten years.
Because remember, if I have now given you the ability
(07:37):
to now walk on your knee, to be able to
go back to all your activities, to be able to
now go swimming, go bike and go hiking, go playing
with your grandkids, the fact that I'm now masking that pain,
but you're still wearing out your knee joint. That does
mean that your knee will still continue to deteriorate.
Speaker 3 (07:55):
So would it be a good thing to also do,
like maybe some kind of physical therapy along with the
person that you're doing exactly.
Speaker 2 (08:02):
So that's exactly you've kind of teed it up for me,
because this is exactly the thrust of what I wanted
to talk on this show because a lot of patients
asked me, so what can I do? What should I
do to minimize that long term damage? Because by coming
to me, I've now made them pain free, or maybe
not pain free totally, because some folks say, you know what,
(08:23):
I am at ten out of ten knee pain, but
maybe now I've gotten them down to four out of
ten or two out of ten, so you're still going
to have a little bit of pain. It's very difficult
for me to wave a magic wand and say I'm
going to make you completely pain free and you're like
a twenty year old, but you're still going to have
maybe a little bit of pain. It's almost like imagine
(08:43):
you have a light bulb and you have a dimmer switch,
and so I'm now dimming it, but I'm not completely
turning it off. But I'm now giving you enough pain
relief to where you can go back to your activities. Now,
what's the downside? Just what you mentioned, you could potentially
make your knee joint worse. And that's exactly where I'm
going to go with this next segment, which is what
are these sort of exercises and physical therapies that are
(09:06):
recommended and identified as the best options for folks out there.
Speaker 3 (09:12):
To back your view, you're listening to the Medical Hackers
with doctor Sandeep Rau, board certified vascular interventionalist bringing you
insights on treatments for common medical problems on news Radio
six ninety KTSM. For more information on the issues being discussed,
or to contact doctor Rao call nine one five five
zero zero four three seven zero or by emailing Rao
(09:33):
at medical hackers dot com.
Speaker 2 (09:36):
Background The Hackers, Doctor out Here and Jury to Break
Ambers cooled me on different types of lunges, which is
which I think is a good intro into getting into
what we do for folks who have arthritis and the
exercises that are recommended. So first off, it's important to
know when it comes to ne arthritis, not all exercises
(09:56):
are equal. So there's a lot of different types of
exercises that that are recommended bydocs. One is something like
an aerobic exercise where you're kind of maybe just kind
of doing constant motion, maybe cycling, you know, biking, maybe swimming.
To a certain degree, folks include for you walking and
(10:18):
i'd be considered a true aerobic exercise.
Speaker 1 (10:20):
More and more probably more running.
Speaker 2 (10:22):
But when you're talking about folks who are carrying a
lot of weight having difficulty moving, you know, we include
walking in that same category. There.
Speaker 3 (10:29):
Walking is definitely underrated.
Speaker 2 (10:31):
Yes, Now there's other types of exercises that are also
identified what we call, you know, neuromotor exercises. These are
exercises that folks do where you have to involve balance
and coordination. Now, what is a good example that something
(10:51):
that like dance? Yeah, you're right, you know, so that
in something if you are you know, you're if you're
going out and you're dancing, you're obviously enjoying your self,
but you're also we have to kind of be a
little bit coordinated. If you hopefully you look coordinated on
the dance floor, but you know, especially if you're doing
like something like maybe a partner dance or something. You
have to be you have to really be able to know, oh,
(11:11):
I'm making this step and going forward or going backwards
at the right time.
Speaker 3 (11:16):
And I think people have to be careful with dancing
because they think, oh, I'll go take a dance class
at the gym. And then there's a bunch of like
jump lunges, which are jump squats, which they probably shouldn't
be doing less they know how to do a proper squad.
Speaker 2 (11:26):
Oh absolutely, Oh I've done jump squats. It's been a
while since I've have to do a jump squad.
Speaker 3 (11:30):
They're horrible.
Speaker 1 (11:31):
That was almost to me.
Speaker 2 (11:31):
A jump squat has got an X. It's got a
component of aerobic activity to it because you're constantly it's
almost like you're running, but you're doing it from a
squat position.
Speaker 1 (11:39):
So but but anyway, digressor.
Speaker 2 (11:43):
So when it comes to aerobic activities and these other
this other category which called neuromotor exercises, and some folks
also talk about mind body connection activities. So an example
that might be yoga or high chi. So there's actually
a study here that was done by the British Medical Journal.
(12:05):
So they looked at a bunch of these different exercises
that were prescribed to patients. They looked at two hundred
and seventeen different trials that were out there, and they
looked at how they all compared. Now, But what do
you think was the best thing if you have ne arthritis?
Obviously you're not a doc, although hopefully I've given you
(12:26):
good information over over these years. But if you had
to think, you know you have, if you had some
old patient came in and said, I'm dealing with a
lot of knee pain, would you would you recommend?
Speaker 1 (12:38):
What do you think is going to be the.
Speaker 2 (12:40):
Best for their short term gains maybe long term gains.
Do you think it's gonna be the aerobic exercises. Do
you think it's going to be something like these mind
body things that I mentioned, like a yoga, like a
tai chi. Do you think it's going to be a
recommending something like dance? What do you think?
Speaker 3 (12:54):
Well, I've actually had you know, I have a background
in personal training. I've had older clients with issues like that,
and what I would probably do is body weight bandit exercises,
you know, put the band around the knees, body weight stuff. Honestly,
some type of resistance training. No cardio, yet no group
classes that would be my recommendation body weight and bands.
Speaker 2 (13:15):
Okay, so that's definitely you know, that's within the realm
of what they recommended. But I'll just tell you. So,
so what they found is with this two hundred and
seventeen trials that they did, and this was our studied
PERO done from nineteen ninety to twenty twenty four, so
it's almost over a thirty five year period of time.
Fifteen thousand participants were in this overall these different studies,
(13:37):
and they looked at time points about four weeks after
starting training, twelve weeks and twenty four weeks, Okay, so
they kind of divide into short term, medium for lng term.
And so what they found was that when it came
to short term pain, aerobic exercise was the most superior
form of treatment. So what do they mean by aerobic exercise?
So they recommended things like swimming, cycling beyond a little
(14:01):
cycling bikes like one of those maybe stationary bikes. Yeah,
And then they found second was what we call mind
body exercises, so stuff like something like yoga, which also
includes you know, forms of stretching as also is within
that cat.
Speaker 3 (14:17):
Doctor if I can interrupt the aerobic exercise. Though they
mean more low impact, right, I wouldn't they meant like,
you know, no cheeses and running and springs, no jump squads,
you know, not the combat bike, but the course.
Speaker 1 (14:28):
Right of course.
Speaker 2 (14:28):
So that's why when I said Arabic, I know, Arabic
means different things for different people.
Speaker 1 (14:32):
You as with your training background.
Speaker 2 (14:34):
If you're recommending, you may not think initially, oh, let's
just put it do a little bit of you know, swimming,
that may be very very low impact, right, And honestly
that's what you need when you have this much damage
that's already occurred to your knee joint. And so now
what they did find is that, you know, Arabic Exercis's
head saw the most improvement with gate performance. So in
(14:56):
terms of the way you walk, they found the most
improvement there at twelve weeks. But then when they started
looking at sort of even long term improvement, they actually
found folks who do these neuromotor exercises which addressed like
you know, postural control sensation like dancing, any sort of
coordinate activity, actually had really good impact from a long
(15:17):
term perspective as well. So but overall, the aerobic activity
just overall blew away the entire competition when you look
at that short term quality of life improvement. So when
you started looking at four weeks doing some of that,
you know that just constant motion, like slow, low, you know,
low level impact motion was the one that was most affected.
(15:40):
Now you might wonder why why would this type of
an activity be helpful, So when you started looking at
things like walking, cycling, swimming, as you said, it has
sort of less impact on the knee as opposed to running,
where you're running strong linder, whether it's a treadmill or
whether you decide to go run around.
Speaker 3 (15:59):
The lock and jump pound have good running dynamics for sure.
Speaker 2 (16:05):
Now, what that does is that actually stimulates the production
of a fluid in your joint space called the synovial fluid.
So you might think of that as like, you know,
like a little bit of oil for the rusty hinges
in your knee. So that's what any of these activities
helps stimulate it. And you want to stimulate the production
(16:25):
of this synovial fluid because it really helps lubricate that joint. Now,
the other thing it does is by hydrating that joint,
it helps prevent further wearing out of that carlage. So
your you know, your bone is there, it's colored with cartilage,
and your carlage is probably already worn out a bit
if you have arthritis. And so by hydrating a little
(16:46):
bit with this synovial fluid, this joint fluid, by stimulating it,
that should help further prevent ongoing damage. Now, some folks
get gel injections. Some folks call it, you know, classically
rooster comb injections because in the past they actually got
a lot of this gel. It was extracted from from
(17:08):
the from a rooster. But that people folks classically call
it rooster comb injections, although we don't really use that
as sort of an old school term for it. But
gel injections is something that also is designed to to
sort of simulate that synovial fluid that's released in your joint.
But as I said, so, what's one of the things
that folks wonder about is what about the immediate impact,
(17:30):
Like is there anything that by doing these activities that
does it help me immediately? And that's where you know,
endorphin release. Whenever you're running, it's almost endorphins are sort
of released by your body, and it's sort of boy,
your body's natural painkiller, and so that can always help
you out just by getting up moving. And so when
(17:50):
patients come and ask me, I tell them I think
it's good to have some low degree of movement. But
if someone's telling me I can only really do some stretchingercises,
that's not gonna hurt. But there's other stuff that's better
out there. So it's in general, it's always good to move.
And so I think, you know, when we look at it,
so walking overall is just not as good compared to
(18:13):
cycling or swimming, just because there's a little bit more
impact loading on that knee joint. But I don't want
folks to, you know, listen to this and go, I
don't have access to a swimming pool, I don't have
access to a bike, and then not do any exercise.
So I don't dissuade anybody, but I just kind of
tell them, you know, these are sort of what's available
out there, and it's it's good to do weight bearing
(18:37):
exercises in general, though as you get older, because that's
as you know, as a as a strength training, you
know that it's good to be able to maintain that
muscle that you need, because another component of that knee
health is not just keeping that joint well lubricated, but
also strengthening those muscles. The quarter step, the same exercise
(18:58):
we were doing during the break where you're showing me.
Speaker 1 (19:00):
How to do a proper lunge.
Speaker 2 (19:03):
You know, it is good to have that quad step
muscle which is on the top of your knee, have
it nice and strengthened, because that's going to be a
significant significant impact on overall lowering the impact on your
knee joint.
Speaker 1 (19:15):
So I'm gonna take a quick break.
Speaker 2 (19:16):
Here and talk a little bit further about a common
question that I get as well.
Speaker 3 (19:23):
You're listening to the Medical Hackers with doctor Sandeep Rau,
board certified, a vascular interventionalist, bringing you insights on treatments
for common medical problems on news radio six ninety KTSM.
For more information on the issues being discussed, or to
contact doctor Rao, call nine one five five zero zero
four three seven zero or by emailing Rao at medical
hackers dot com.
Speaker 1 (19:45):
Soy Amberg, have you ever heard a patient say.
Speaker 2 (19:49):
Maybe they could they could sense that a storm was coming,
or maybe they feel like they feel like the temperature
is gonna draw.
Speaker 3 (19:58):
Because their knee starts hurting. They're like, storm's coming.
Speaker 2 (20:01):
I'm like, okay, yeah, so that's it's definitely a weird
sort of a question because I actually had a patient
yesterday who to ask me. And I've had this question
asked to me multiple times from different patients, and they'll say,
I've noticed that the temperature is changing, it's getting a
little cooler. Why do I feel or maybe it's raining
(20:21):
a little bit more. Why do I feel like my
joint pain is flaring up?
Speaker 3 (20:27):
Yeah?
Speaker 2 (20:28):
Well, I'll first cut to the chase. So there's no
significant scientific data that is connected x, like you know,
a temperature change drop or a change in the barometric
pressure outside and shown exactly why that has led to
a change in joint dysfunction enjoint pain.
Speaker 1 (20:49):
So that's the bottom line.
Speaker 2 (20:51):
However, I want to kind of get into this because
there are a lot of theories, because I see this
question raised often enough that sometimes you don't need to
have scientific data to think you want maybe there is
something there where a lot of patients are asking me
about the exact same question, the exact same complaint, and
I want to kind of get into this a little
bit more. So, what are some theories about why weather
(21:13):
confect your joints? So one thing is that it is
now getting a little bit cooler. So cold temperatures can
cause your blood vessels in generally any part of your body,
it caused it to constrict, meaning it caused it to contract.
So it gets it to cause it to get smaller,
because what it does is it reduces your blood flow.
So if you think about it, imagine if you put
(21:35):
your hand, your hand in icy cold water, what's going
to happen is all those blood vessels in your hand
are going to shrink down.
Speaker 1 (21:45):
Now why does your body do that?
Speaker 2 (21:47):
Because the blood system is sort of a conduit to
where any sort of a connect, your connection to the
outside world. So if you get a lot of cold
from the outside, your body wants to maintain its core
temperature of warmth. And so if there's a lot of
blood flow going through your hand, and now that blood
(22:07):
flow is being exposed to all this cold, now you're
gonna now make your whole body cold. Does that make sense?
But now by making by your body naturally constricting or
contracting those blood vessels, now less blood is going to
go to that hand, So now there's less blood exposed
to the area where there's cold. So that way, it's
almost like imagine like I don't know if it's a Honestly,
(22:30):
I don't have a good example. I was thinking about
ice cubes, but that's not a good example because ice
cubes obviously they dissipate, they melt, they melt, right, But
if you think about it, you know when you have anything,
that your blood is the way you are exposed to
your environment. And so when you have a lot of
blood flow in an area where there's a lot of cold,
(22:51):
you don't want as much blood flow there. You want
to have less blood flow because you want to maintain
your your good normal body temperature. So just that overall concept,
whether you have knee pain or not. When you have
knee pain, the same blood vessels in your knee joint
theoretically constrict, they get smaller, they reduce your blood flow
(23:12):
to that knee joint, and so folks think that that
increases the stiffness in your knee joint when the temperature drops. Again,
this is a theory, right, they haven't done scientific tests
to say, you know, done one hundred different patients and
figured this out. But this is a theory about why,
one theory about why cold temperatures can cause increased stiffness
(23:35):
with arthriaves.
Speaker 3 (23:35):
Can I give you a theory?
Speaker 1 (23:36):
Sure?
Speaker 3 (23:38):
Well, didn't you say that some of the new replacements
there's like steel in there. Yes, wouldn't the steel get
cold if it's colder?
Speaker 1 (23:43):
Oh for sure.
Speaker 2 (23:44):
But I'm actually talking not just about patients who've had
knee replacements. I'm talking about actually the vast majority of
patients who come to see me.
Speaker 3 (23:50):
Pain without a replacement.
Speaker 1 (23:52):
Oh of course, exactly.
Speaker 2 (23:53):
Oh so I do have a bunch of patients who
have not had any knee replacements. They just have underlying arthritis.
And they will tell me, you know what it was.
It started raining this past week and the weather has
been getting cooler, and now I'm feeling more joint pain.
They have not had any surgeries, and they asked me
about this. Another thing is that what about the changes
in the outdoor pressure. So it's changing the barometric pressure,
(24:16):
and so if there's some storm system coming in changing
that pressure, that that can theoretically expand or contract your
tissues around your joint again leading to joint leading to pain. Now,
another thing is that humidity. So some folks think that
when you have high humidity. We don't get that, thankfully
high humidity in West Texas like you get it sort
(24:36):
of an East taxes. But that can increase the moisture
in your joint, just high humidity, and that can make
inflammation and pain worse by having more moisture in your joint. Again,
I don't really understand that concept. This is just a theory, right,
but people.
Speaker 3 (24:56):
That it's worth investigating.
Speaker 2 (24:58):
And so, so what about you know, so when folks
have so what we have seen in general is when
folks have arthritis and it's really cold. To me, when
it's really cold, you don't want to go outside, so
you're probably stuck in bed. And the more you're inactive.
To me, that corresponds with you are not your inactive,
Your joints aren't moving. As I said, by moving, by swimming,
(25:19):
you're creating more snovia fluid by that helps lubricate that joint.
So that's my thought is that you know, you have
patients with arthritis have more pain because it's cold. You're
not moving now too, Folks with the rheumatoid arthritis, which
is not arthritis, is the vast majority of patients. We
see the vast majority of patients of arth threats. But
there's this condition called rheumatoid arthritis, which is I don't
want to get into it, but it's a we call
(25:42):
it an autoimmune inflammatory condition, which is also known to
be worsened by weather changes. And they found that cold
temperatures and humidity can't trigger flare ups.
Speaker 3 (25:52):
What about issues with you know, patients that go in
and maybe they have knee pain on one side and
they get the surgery. I know, like there's some people
that are worried about maybe the other leg being affected
because it's going to have to compensate. Yes, Like, do
you have patients that go in up with that?
Speaker 1 (26:07):
So I have patients who come in.
Speaker 2 (26:08):
They'll come in with pain in both knees, but they'll say,
you know what, my pain on my right knee is
eight or nine out of ten. My pain in my
left knee is about two or three out of ten.
But it's slowly creeping up. And when we do the
x rays, we find out that one side that maybe
that right knee which had nine out of ten pain,
has worse our stritus. The other knee has a little
(26:31):
bit less but it's creeping up. So they ask me
which one should I treat first, what should I do?
And so usually when I do these treatments, where I
go in, put this medication in, and I'm able to
get rid of their pain in that the really bad
knee in this case, this example, the routney which has
worse arthritis, worse pain. They'll tell me after the procedure,
(26:51):
not only do I feel better on my rotney, but
my left knee is also starting to feel better.
Speaker 3 (26:57):
Now.
Speaker 1 (26:58):
The reason for that is the.
Speaker 2 (26:59):
Thought is that you know you have been affecting the gait,
You've been changing the way you walk to compensate for
this knee pain. You may have eve been putting a
lot more pressure on your good or better knee, your
left knee. And so by me taking the pain the
pressure off that knee by making your worse knee better,
your right knee better in this case, now there's less
(27:21):
pressure on that other knee. So now I've now magically
not just treated your one nee, but I now also
helped you with your other knee. So that's something I've
noticed many often, and so in that case I don't
really try to treat their leftknee. But I'll say, you
know what, if you want, we can go after it.
It's not a big deal, but it is something to
(27:42):
think about. But that was a great question, and unfortunately
our time the Saturday's up.
Speaker 1 (27:46):
If you aren't interested in any more.
Speaker 2 (27:47):
Information on any of the mentioned minimum invasive treatments, you
can always call to get more information at none one
five five hundred forty three seventy that's five zero zero
four to three seven zero. You don't so reaching me
about email at raw that's my last name, r AO
at medicalhackers dot com. I hope these healthcare hackers have
(28:09):
helped you navigate our complex medical system. If you've been
tuned into us this whole time, bless your heart and
your health. I'm doctor Sandy Brow, and you've been listening
to the medical hackers
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