To cut or not to cut, that is the question

It’s not a stretch to say I don’t trust doctors.

Many years ago, I suffered from GERD, a chronic digestive disease that feels like a near constant heart attack. Despite overwhelming evidence that fatty, sugary foods exacerbate GERD, not one doctor recommended I make dietary changes, such as giving up dairy products. (Even low-fat dairy products can be problematic. Sugar — in the form of lactose — contributes about 55 percent of skim milk’s calories, giving it ounce for ounce the same calorie load as soda.)

Instead, I was prescribed Prilosec, which it turns out gives me hives. Hmmm…hives or heartburn…Can you say “crappy choice”?

I don’t hold it against doctors for resorting to drugs. We live in a country where most patients have the unrealistic belief that good health is primarily a product of medical science rather than primarily the natural consequence of a healthy lifestyle and environment. In this world of commercially-distorted medical care, drugs are what patients expect and what doctors have been taught to provide.

All of this is to say, I’m deeply skeptical of doctors’ advice. And I’m especially skeptical of doctors whose sole training in fixing your particular problem is surgery. Think about it: They make the most money by operating on you, so it’s in their best interests to sell you on surgery as a solution! What else would they recommend?

To give my orthopedic surgeon credit, he didn’t immediately say I had to have surgery. He did say, however, that if I expected to continue climbing, skiing, and mountain biking, that I really needed to seriously consider it. “Having a torn ACL is like being partially pregnant,” he concluded.

torn acl

I wasn’t sure what that meant, but I did understand that my best chance to have a stable knee and an active lifestyle without more pain and injury was probably surgery and a long course of rehab. For every recommendation for surgery I found, however, I was running into people with torn knee ligaments who felt like rehab alone had been the best choice for them.

Ack! What was I supposed to do?!

My decision to go under the knife was cemented when I discovered research explaining that the ACL is unique in the body, in that it is one of the few ligaments in the body that cannot repair itself. Here’s what a team of scientists found:

Dr. Martha Murray, an orthopedic surgeon at Boston Children’s Hospital and Harvard Medical School, and her colleagues began by studying the knee’s interior microenvironment and noting that the ACL was constantly awash in synovial fluid, which lubricates the knee.

They then picked apart the synovial fluid microscopically and found that it contained an enzyme that dissolved blood clots. This attribute is desirable; you don’t generally want blood clumping inside your joints.

But blood clots can also speed healing, because they “provide a bridge” between the torn edges of damaged tissue over which new tissue can grow, repairing the tear, Dr. Murray said. The knee’s medial collateral ligament, for instance, which is not bathed in synovial fluid, develops a blood clot after a tear and repairs itself. No such clots cling to a torn ACL, and it never becomes whole.

This also explains why doctors currently replace torn ACLs instead of trying to stitch the existing one back together. A-ha!

I’m looking forward to the day when doctors have found a way to repair a person’s own damaged ACL. Until then, my choice is clear. Surgery is scheduled for 9:30 a.m. September 24th.


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2 responses to “To cut or not to cut, that is the question”

  1. Vera says :

    I climbed for 3 years after I fully ruptured my ACL. I also did kick boxing, ice skating, mountaineering and other things.. But.. The knee was never the same prior the injury. You did the right thing. I have re-injured my knee a few times since the first accident. Did some damage to both menisci and finally decided to fix it. Should have done it ages ago but I’m stubborn and I believed I could do it without an op. 🙂

  2. Textly says :

    I climbed for 3 years after I fully ruptured my ACL

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