High on the list of things making me angry is the weather. A foot of snow each week? Really, Mother Nature? Really? Global warming or not, it’s wearing on us. I’ve tried making idle threats against the earth, which go something like this – “Make the snow stop or I swear I’ll never recycle anything ever again! Look at me holding this peanut butter jar! It’s going in the TRASH. That not enough for ya? OK, I can do better. Here’s a laundry detergent bottle! OOOOH all that plastic, bobbing around in your oceans. Gonna stop the snow now???” Yeah, well, I think all the snow is making me loopy. Not to mention that we’ve had so many snow days causing patient cancellations that it’s really fouling up everyone’s schedules.
What else makes me angry? An article with the headline “Docs Don’t Follow OA Guidelines.” Why so accusatory? In my mind that headline assumes there’s a bunch of guys smoking cigars sitting around a table saying, “To hell with guidelines! We don’t care about guidelines! We’re doing what we want!” (I don’t know why it’s like a 1920’s mobster scene, but that’s my vision here).
Here’s the first paragraph:
Physicians are apparently disregarding standard guidelines to manage osteoarthritis — relying on painkillers and surgery rather than on steps like exercise and weight loss that could help reduce morbidity — adding to the soaring costs of treating OA, researchers argued.
Let’s think about that for a minute. A patient comes in with osteoarthritic knee pain. Usually it hurts when getting up after sitting for a while, hurts going up and down stairs. Maybe they’re already active and it hurts when exercising. Maybe it used to respond to an OTC analgesic but isn’t anymore.
I am fairly certain that most doctors almost always if not always counsel patients with OA about diet and exercise. I’ve given the “even a little bit of weight loss would help take some pressure off your knees” talk so many times I wouldn’t be surprised if I say it in my sleep. But here’s the clincher – diet and exercise are the PATIENT’S responsibility. I can’t go home with you and cook your food (though I can help you find some great internet resources for healthy eating) and I can’t take you to the gym. I have enough trouble getting myself out to exercise and to avoid the lure of the office candy bowl! But when patients come to the doctor they expect us to DO something. Dieting and exercise are slow. They’re hard to do. Your knee still hurts when you’re exercising. Painkillers, injections and even surgery can help you feel better as youre working on healthier lifestyle modifications. So please don’t tell me that I’m “disregarding guidelines” by recommending other treatment options. I’m just trying to help.