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Bad knees


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Well, the week from hell is over and everything turned out ok in the end :)

 

My stance, which I think you agree on going from your posts, is that medicine has a scientific base. I am not, and would not, argue that the practice of medicine is a scientific discipline. Most people will have had experiences of good and bad doctors, and good doctors are normally described as having a good bedside manner, that indefineable and unteachable combination of charm, humour and communication skills.

 

The other factor in medicine is that most of the time you can only go on what the patient tells you. Intelligent questioning can provide some useful insights. This causes problems because although we might know the biochemical basis of the illness it is not always possible to measure the markers in a patient. If we look at depression as an example, it is thought to be caused by low levels of monoamines (i.e. serotonin, noradrenaline), but measuring levels of these in patients is difficult as to assess CNS levels you would have to take CSF samples, which is not something GPs can (or want to) do, but trials have shown that agents which increase levels of monoamines are effective in depression. This argument is true for many conditions and doctors have to make a diagnosis based on symptoms the patient (or their carer) describe to them and the parameters that can be measured. Patients also have a tendency to not take the medication they are prescribed properly, making evaluation of their condition more difficult.

 

Increased diagnosis of conditions can also reflect increased awareness of conditions, or changes in the guidelines for conditions. Diagnosis rates can shoot up simply because GPs are more aware of a condition (I'm particularly thinking of CNS conditions here.)

 

I've not had time to look for stats about different rates of myringotomy, tonsilectomy or appendictomy in the UK, though I have thought of a reason the rates could be different in different aussie states. If different states in Australia have different laws, this could explain the difference. If the law surrounding medical negligence is different in different states in Australia, doctors in states may decide to err on the side of caution to prevent legal action by patients in the future.

 

So what is the science underpining the practice of medicine? From what I know (and the school of pharmacy I'm at doesn't collaborate with the nearby medical school), medicine is based on anatomy, physiology, pathology and pharmacology (though you could make an arguement for doctors passing prescribing over to pharmacists, but that maybe is a topic for another thread), obviously the exact content will depend on the specialities of the university.

 

It is likely that some alternative therapies will be accepted into the mainstream, particularly those involving herbal medicines. Taxol is a fairly recent example of a drug obtained from natural sources. One of the main advantages of conventional medical practice is the fact that you know the medication you recieve adheres to certain standards (also an argument for liberlaisation of drug laws). Some herbal products have been withdrawn from the UK market, most notably kava kava due to hepatotoxicity, and there have been cases of skin creams being alduterated with corticosteroids. Standardisation of active ingredients is also an issue.

 

I'm know the healthcare system in Australia is different to that in the UK, where most people have their treatment funded by the government. My argument is certainly biased by the system we have in the UK. If the government is funding the cost of treatment then the standard of evidence needed for the NHS to fund a treatment may be higher than that in countries where the patient pays most, if not all of the cost.

 

One of the key parts of my undergraduate pharmacy education, and I'm sure it's the same for all health care professionals, has been to enable us to discriminate between those cases we can treat and those that need to be referred on to someone else. Does this happen with alternative therapists? Another point regards regulation. There is a distinct lack of regulation for alternative therapists. Often they do not even need to register with anyone, and so cannot be disciplined.

 

Regarding Dr. Holt, there's not enough infomation on that site really, though I have read about use of porphyrin (a photosensitiser) and light, so it seems plausible (though some of the links on that page are, quite frankly, barmy).

 

One final thought: one man's rat poison is another man's life saver.

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  • 12 years later...

I used the inversion table while in martial arts. It is pretty great. I also found that knee pain tended to be a sign of tight hamstrings and putting both legs out flat in front of me and doing stretches where I reached for my toes tended to help quite a bit, too.

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  • 2 weeks later...

I've had a bum knee, from doing BJJ, since 2012.  Before I couldn't run or it would be sore to the point where I couldn't walk normally for a month.  I started doing Krav Maga going at a pace my injury would allow me to go and it got better.  I was able to jog and do squats which I couldn't do before.    I'm hoping that by losing weight it won't be a severe as it is now and it can go back to normal?

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6 hours ago, Kylo RenSkins said:

I've had a bum knee, from doing BJJ, since 2012.  Before I couldn't run or it would be sore to the point where I couldn't walk normally for a month.  I started doing Krav Maga going at a pace my injury would allow me to go and it got better.  I was able to jog and do squats which I couldn't do before.    I'm hoping that by losing weight it won't be a severe as it is now and it can go back to normal?

 

 

!

Moderator Note

It is best you seek advice from your doctor, not the internet. 

 
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