Snap! Severe stabbing grabbed Deb Daniels in the right knee causing her body to collapse as the pain and weakness wouldn’t allow her to go further down the stairs of the home hospice client on September 17, 2008. She was giving massage therapy to those not long to remain on earth. With a single step her world was turned upside down. Fortunately the home hospice was equipped with a wheelchair, and the home owner assisted her into her car. She was able to drive, but could not accelerate her car over 40 mph. She drove herself to urgent care. After arriving at urgent care she called inside and a staff member came to the car with a wheelchair to bring her inside. The emergency physician ordered x-rays, fitted her with a full length leg brace and issued a pain pill prescription. His recommendation was to make an appointment with a surgeon for 1:00pm the next day to evaluate her severely swollen and painful knee for a knee replacement. She had to borrow a wheelchair from her hospice employer to get around in her home.
Debi, who had 17 previous surgeries including 2 arthroscopic knee surgeries, had learned well by now that all roads for a 50+ year old with severely swollen and disabled knee would inevitably lead to an 18th surgery. Her years as a massage therapist gave her an insight that orthopedic surgery was not what many hailed it to be. She had seen so many clients have such considerable pain and disability in the recovery and long term that she was determined not to have this scenario repeated in her own life. She was able to get an appointment for 8:00am the next day at Dr. Faber’s office. She knew he offered workable alternatives to orthopedic surgery and drugs as she had given him professional therapeutic massages and had attended his educational meetings.
“Oh my God!” Kathy Rogers exclaimed as she sat at the front desk looking at the street by the front door. She said, “Whoever that is, they are having a terrible time getting out of the car.” She looked at the schedule and said, “I think that is our new patient.” Poor Debi had to negotiate getting out of the car with a lot of help from her husband as well as one step up the curb and one step to the clinic door. Debi had beads of sweat on her forehead from the effort and pain it took to maneuver with the full leg brace and walker. Kathy quickly apologized and said, “I didn’t know you were so impaired. We have wheelchair access at the back parking lot.”
Debi painfully made her way to the exam room and was heavily assisted onto the lowered position of the power examination table centered in the large examination room. Dr Faber came in quickly and got the recent “snap and total disability” story. He also reviewed her medical and surgical life history and found the previous arthroscopic knee surgeries and the 15 other surgeries to her abdomen. On close questioning Debi admitted that the knee had been a problem for some years and that she would feel it “shift” on movement for some time. Dr. Faber noted she had diabetes and blood pressure issues also.
Now armed with her presence and her detailed story, Dr. Faber started his osteopathic physical examination. The usual step of examining her gait, stair climbing, squat and getting out of the chair wasn’t possible, Debi had just too much pain and immobility. This is important information to obtain as it can lead to diagnostic clues leading to what treatments may be effective. So you have to go with what you got. The full-length brace was removed revealing a swollen knee. On examination the slightest bending of the knee gave Debi increased pain, causing her to yell. With his osteopathic trained, knowing, sensing hands, Dr. Faber lightly examined all areas of the knee cap, above the knee joint, on the inside and outside of the lower thigh. He did the same below the knee joint. His hands examined lightly at first, noting the skin, its temperature, dryness or dampness, whether it was freely moving or restricted, and whether there were tender, swollen areas. He indeed found swelling or thickness in the superior lateral (upper, outer) aspect of the knee. This was confirmed when he examined deeply the fascia under the skin, then the subcutaneous tissue, then deeper still to the muscle again sensing all the above parameters and then finally examining down to the bone level.
In examining the knee joint in this fashion he found that the medial cartilage was badly worn and most likely frayed. He could tell that the medial collateral ligament was also weakened and not giving full support to the joint. Similarly he found on the outside of the knee that the lateral meniscus or cartilage was also worn and frayed and that the lateral collateral ligament was also weakening and not supportive of weight bearing on the knee. He determined that the cruciate ligaments were adequate. He examined her posterior (back) knee and found the condyles (articular surfaces) were acutely painful indicating wear on the bones. In this process he checked the state of intactness of the tendons surrounding all areas of the knee and concluded they were not culprits in causing the pain and disability. He formed the diagnoses of: 1. arthritis of the right knee joint, 2. medial and 3. lateral meniscal (cartilage) wear and fraying (arthritis), 4. sprain of the medial and 5. lateral collateral ligaments, 6. Medial, 7. lateral condyle micro-articular damage, and 8. Hemarthrosis effusion.
He then asked the patient if immediate improvements in her pain and inability to walk would be acceptable. Debi looked somewhat quizzical but replied, “Yes.” [Dr. Faber explains that he has applied dramatically corrective therapy many times prior without pre-warning the patient and has found that the sudden results actually disturbed some patients to such a degree that he could sense their mind actually worked against the fact that a tremendous healing had taken place. The informing of the patient of the expected result he has found greatly reduces this possible mental upset and permits a deeper response.]
Dr. Faber proceeded with the plan which he had explained to Debi. First he drew off blood which he detected lying deep in her knee joint. He obtained 13cc indicating tearing of the knee structures when she heard the “snap” and sensed the stabbing pain. He then proceeded to inject dilute non-numbing doses of preservative free lidocaine. This was to promote drainage, circulation of the damaged tissue and has a cell stabilizing and nerve calming effect but no numbing effects on her deep knee cartilages both medial and lateral (inside and outside) of her supporting collateral ligaments. Then he injected a hypertonic (concentrated) calcium, dilute lidocaine and saline mixture into the posterior condyles to stimulate repair of their micro-damage. Debi tolerated the non-allergic, non-toxic, preservative free injections well. At this time her knee was again flexed. It moved further and with much less pain. Dr. Faber lightly stroked his hand all over the knee, telling her, “Your knee is not anesthetized; it doesn’t feel like after the dentist injects you.” At this point he helped her off the table and said, “Walk.” She tentatively took one step, smiled slightly and followed this step with more walking around the exam room. Then she was asked to sit in the chair and stand up. She did without the terrible pain and inability she had previously and walked unaided. She carried her walker out of the room after some tears of relief. She and her husband went straight to the medical/surgical pharmacy Dr. Faber told her about to replace the full length non-bending knee splint with a flexible, fitted, off the rack knee support. He told her to wear it all the time when she was up so as to help support the recently injured and degenerated knee.
They then cancelled her appointment to have the knee replaced by the orthopedic surgeon and worked at the Avolen Spa all day and each day until the next week when she returned to see Dr. Faber as instructed. She reported doing very well. Debi had 8 more treatments over the next 8 months, receiving the last treatment May 4, 2009. She has since had a very vigorous treadmill stress test and her knee gave her no problems. She reports doing well as of this writing in April 2012 which is 3 ½ years after her injury. She has taken no further treatments or medications for her knee.
Individual results may vary. Data is from clinical experience. Information is for educational use only. Consult your physician for all medical advice.