This Week's E-Edition

Research may be best medicine for health issues


Claudette Hollenbeck

“Dem bones, dem bones, dem dry bones ...”
Ah yes. The older we get the drier and more achy those bones can get. According to AARP, “A whopping 700,000 surgeries are performed each year in the United States to fix tears in the meniscus, a piece of tissue between knee-joint bones. Tens of thousands more get joint injections of hyaluronic acid.” I, myself, have had to have both knees replaced entirely because of osteoarthritis. It has become a very popular surgery, but not without risk.
A very good friend of mine just took quite a different route. She must be the world’s most diligent researcher. After consulting one doctor in Boston who was unwilling to do knee replacement surgery on her due to various health factors, she consulted two more in Boston and one at Dartmouth. All three of them were willing to do one or both knees but each set different conditions. Who knew there were so many opinions and options?
Not happy with the variety of advice, she went online and discovered that there is now a new way to address a torn meniscus: stem cell replacement therapy. She tore hers while climbing a flight of stairs about six months ago. Most of us go to the nearest orthopedist with a good local reputation and do what that doctor suggests. Maybe a few go to get a second opinion. She, on the other hand, traveled all over the place to meet them face to face so she could make her own evaluation.
She explained her process to me saying, “I wanted someone who was a surgeon, an orthopedist, and a sports medicine doctor, who was aligned with a university medical research center, not some guy in a strip mall office.” There are 600 doctors who do stem cell replacement and she selected a Rochester fellow who met all her criteria. He did not need to do a full replacement, just arthroscopic surgery to stitch up the tear in her meniscus cartilage, and to clear out the debris that had accumulated in the joint. Under anesthesia, he extracted some marrow containing her own stem cells from one of her bones, ran it through a centrifuge to separate out the stem cells, and then injected those into her knee joint. She said the pain was a 10 on a scale of 1-10 in the first hour, and, amazingly, zero thereafter. She is perking right along now, following up with physical therapy to restore muscle strength that she had lost after the original injury.
She spoke to six people who had had this surgery and were all out skiing and playing tennis, happy as can be. The downside is that the stem cell part of this is not covered by insurance and cost her $3,000 out of pocket. However the meniscus repair, anesthesia, and hospital costs were covered by insurance.
I went online myself to see what the word is out there on stem cell therapy. As per usual, the medical world is very cautious and slow to accept something new until it has been tested by time and experience. This is a good thing for the most part. However, if the sand is running out of your hourglass at an ever increasing speed, and you are in pain, there is a case to be made for giving a new thing a try. So far, she is very happy with it. Will it still be a great solution in a year, in five years? We really don’t know.
Although I have worked in five hospitals in my working life, and met and observed more doctors than one person should ever have had to deal with in one lifetime, it came as a surprise to me how many different opinions she was given for the one problem. People do what they were trained to do. Surgeons cut. Oncologists offer chemotherapy. Psychologists do testing. It is human nature to offer what is in the toolbox with which you are the most familiar. One of the reasons the Mayo Clinic in Minnesota is so famous is that they do all their treatment via a team model. Clinicians from various disciplines examine the patient and the patient’s tests and records. Then all those doctors meet together to determine what might be the best course of treatment for this one, particular person.
My daughter’s best friend and boss has rheumatoid arthritis and had been getting her treatment at a local clinic, (near, but not evidently part of the University of Minnesota Medical School team). The doctor there gave her one of those medications we see advertised all the time on TV. They do say in their advertisements that it “could” cause cancer, and in her case it did. It took an awful lot of pressure to get her to go to Mayo which is only two hours away. They changed everything about her regimen. She is now doing very well.
Making the extra effort to get advice from several sources and tapping into the experience of several doctors seems to have made a big difference in the health of both of these women.

The Deerfield Valley News

797 VT Route 100 North
Wilmington, VT 05363

Phone: 802-464-3388
Fax: 802-464-7255

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