I have for years been wondering why I know so many people with multiple knee replacements who would normally not do anything that would warrant even one, let alone multiple knee replacements, get them until one day I had a back injury. I herniated 3 discs in my back to such extent that I could not lay down flat in the MRI. The doctor had to send me to what is called a “stand-up” MRI, which is an MRI standing vertically and the patient, me in this case, sits in a chair outside of the MRI, sort of next to the two sides of it. It is an open MRI.
I never gave it a second thought until I started to heal and started to remember some of the things that happened and which made a huge impression on me and finally I was able to connect a few dots. Here you see the dots connect.
I back up now several years; in fact over 30 years. I used to have this pain behind my left knee and visited my doctor several times. He ran all kinds of knee tests (never a back tests!) and never found anything wrong so he just said “oh well.. go home, here are some pain killers.” I did.
Then about 10 years later we moved and the place we moved to was a very dusty one inside the house–it was a rented house on a termite hill as I later understood–and the dust really bothered my allergies so we invested in a humidifier, and then a larger humidifier so that I did not need to change water several times every day. But this humidifier was very big; it came with two huge water tanks, each many gallons. I used to fill them in the shower and carry them to the machine, load them up and go. One day, I popped my back doing this and ended up taking massive doses of NSAD medications for pain and inflammation and also going to physical therapy.
At one point the therapist set up some cage like trick where he tied himself to me and leaned back so that his weight pulled my lower half away from my upper half, letting my back get a little room between my discs so the fluid sacs could fill.
This treatment was so amazingly comforting that I remember giving this huge smile and it was only hours later that I realized that the pain behind my knee was gone!
I was still too young and way before my doctorate so I gave it little thought only I remember the moment of realization. Then came the big discovery after my doctorate when I popped 3 of my vertebrates in my back. It was at this time that the points started to connect and the knee replacements of so many people suddenly appeared in a different context.
You will not like to read what I write… so if you are looking for a happy ending, close the page. This will not have one. In fact it will end on the note of corruption.
Back to my back. When I injured my back, my left leg said good bye to me for 2 months. I was in a wheelchair. It took several additional months to be able to walk without any walking aid of some sort but part of my leg was still not feeling touch. It was at this time that I remember thinking “what would a doctor say if today, with impaired left leg, I would end up visiting one and not tell the doctor about my back. Would that doctor know it was my back?” Particularly as I started to heal and like now I only get a few toes hurting. If I went to my doctor today saying I had 3 toes on my left foot hurting and said nothing else (I am no longer in a wheelchair), would he have any ideas where to even send me to check what is wrong?
I can tell you right away that yes, they would all, without exception, send me to a podiatrist. Why? It is logical: podiatrist is in charge of pain in the foot and toes. If I have my toes hurt and nothing else, it must be my toes. Right? But if I went to a podiatrist and he looked at my toes that hurt to the touch but show absolutely no defect in any other way, would he send me to a back doctor? Absolutely not!
And here we come back to the knee surgeons who do multiple knee replacements for people who need none: what is their interest to send that patient to a back surgeon even if the pain is actually caused by a pinched nerve in the back? It is money out of their pocket! If they get paid for a knee replacement by the insurance company of the patient, why would they not offer to give one? The Hippocratic Oath says nothing about not replacing a knee that is healthy. It does not harm the patient. It does not cure the patient but causes no harm! And the knee surgeon can get paid. If the knee surgeon sent the patient to the back surgeon, the knee surgeon would get no payment. It is not in his/her interest to send a patient to another doctor!
This is why my doctor–as good a doctor as he was–had no concept of checking my back when the area behind my knee hurt! There was nothing in there for him to send me to a back surgeon–and perhaps he did not realize that it was a pinched back nerve either, since he was an internist. An internist would not have to know–or should they? I think they should. Bu they are not treated and paid accordingly and so they do not make the effort.
Is this legal? Absolutely! Do we all pay for it? You bet. We do pay in multiple ways: First we pay because many people who get these knee replacements (or hip replacements for that matter) are medicare patients and the tax payers pay for medicare. Secondly we pay for it because none of us gets proper medical treatment and we remain sick and get sicker. And we also pay for it because we keep alive industries upon industries that are not needed.
If there were only 2 knee replacements and 2 hip replacements needed per year, it would not have to be a specialty by thousands of doctors who make their living out of it. Of course if the medical system worked fine and we all got healthy faster, there would be less need for doctors and so the oversupply we now have would mean longer unemployment lines. It would also mean less money to insurance companies since healthy people pay less than sick people do so many jobs would also be lost there! Medical schools would suffer since fewer students would apply to a field that is over saturated already. And finally the pharmaceutical industries would take a huge blow since healthy people need no medicines!
Do you still believe your doctor?
I look forward to your comments and opinion.