An 81 year old male came into the office complaining of bilateral knee pain which most importantly was making it difficult for him to run the bases and playing softball that he loves. He was told by his orthopedist that he could have a knee replacement on his right knee whenever he was ready….or when the pain gets bad enough! The patient also had knee pain when he climbed up stairs. He was eating dairy products daily (i.e. milk, some cheese) and was eating eggs several times per week. He was also on two hypertensive medications and carrying a “good size belly” where he could easily lose 15-20 lbs. He also had a chronic fungus infection on both of his feet. He applied Aspercreme® to his knees for pain temporary pain relief.
Patient’s Quick Knee Pain Reduction and Weight Loss
I talked to this patient on the phone about getting EPAT (shock wave therapy) and took a quick diet history and told him before he even received a treatment to stop all milk products, eggs and wheat and just eat whole food. It would save him time and money because I was going to tell him to do it when he came in for his first office visit and treatment.
When he came in he already had some pain reduction in his knees after a few days on the diet. After the first treatment I put him on an anti-inflammatory pea and rice protein meal replacement 2 scoops twice daily (Inflamx) with a mixed meal and snacks from foods off my BED Diet (see acceptable food list ). Because of his chronic foot fungus (and believing this mostly comes from the gut ) I put him on a Fluconazole (anti-fungal medication) 200 mg per day for 14 days. I had him take 2 pills twice daily of an anti-inflammatory joint support supplement called Freedom Joint Support Formula and gave him a shock wave treatment to both knees using both the Focused and Radial shock wave devices.
He returned in a week for his second treatment. He said the treatment “Worked Wonders!” His knee pain was significantly reduced within 3 days. He could run the bases at his last soft ball game. He was happy. He also had lost 4 lbs that week. So he was given his second treatment and told to keep doing what his is doing. Don’t stop with the diet for now, finish the anti-fungal treatment and keep taking his supplements.
Comment: So the patient believes that the EPAT treatments were great! But I reminded him as much as I am a fan of the shock wave therapy that getting off dairy and eggs, starting an anti-fungal program, taking an anti-inflammatory nutritional supplement and doing quad strengthening exercises played a big role. My gut feeling is that the food elimination played the biggest role.
So we’ll do somewhere between 3 to 5 EPAT treatments 5-7 days a part and see what happens. My hope is he continues to lose weight. My bigger goals are to not just getting him to be pain free so he can play better soft ball (which is really important), but have the patient continue to lose weight and eventually within 6 months to a year get him off his two blood pressure medications. If he is open I would like him to do the 5 day per month Prolon - The Fasting Mimicking Diet for the next 3-6 months to get him to that space of weight and blood pressure normalization, as well as the benefits that come along with fasting (central weight loss, lipid reduction, glucose stabilization, inflammation reduction, increased autophagy and stem cell stimulation).
How Most Medical Professional View Join Pain or Osteoarthritis
So most medical people will look at bilateral (both) knee arthritis in an 81 year old as normal “wear- and-tear” with age and this along with some pain is expected. They are not going to think that food (daily dairy products and eggs) could play a role in his knee pain, and really not see a connection between his toenail fungus (his gut/microbiome) and his knee pain.
Well this is my “wheel house!” In 1983 in the first medical practice I worked in in Marina Del Rey (yep 38 years ago!) every new patient was put on a green vegetable smoothie mixed with psyllium seed husks and a few vitamins for two weeks. I saw all kinds of conditions improve on this relatively extreme elimination diet - joint pain, inflammatory bowel disease, bloating and digestive disorders, constipation, sinus congestion, headaches, “foggy brainess”, muscle aches and many more common symptoms people go to a doctor for. Lesson?…food intolerance can cause any and many symptoms that we dismiss as “normal.”
Over the years from doing a lot of different types of elimination diets - eating whole foods and eliminating common allergens such as dairy, wheat, eggs, sugar, alcohol and caffeine at least for a couple of weeks, I’ve observed all kinds of pain syndromes improve just with diet. [References: Diet and Food Intolerance Causing Knee Pain 1) 2) 3) ]
Then when you add treating the gut for overgrowth of certain bacteria, or treating yeast/fungus and improving digestion even more symptoms improve in addition to the benefits from eliminating commonly eaten foods. [Gut Microbiome and Joint Pain References: 1) 2) 3) 4) ]
Now when you add shockwave treatment (focused and radial pulsed sound waves) on top of an elimination diet and treating the gut (anti-fungal fungal therapy) pain can be significantly and quickly reduced more effectively than with the shock wave treatments by themselves. [Knee Pain Benefited by Shock Wave Therapy References: 1) 2) 3) 4) ]
Shock wave therapy (focused and/or radial - I use both in each treatment) has the following physiological effects which can cause pain reduction immediately but more importantly the healing response continues over several weeks. So there can be immediate improvement that wears off in a day or two, but is less than when you started. Then over the next 3-5 treatments every 5-7 days the process of pain reduction and healing continues from the mechanisms below. (See Shock Wave Benefits and Function)
1) Neovascularizatioin –the building of new blood vessels
2) Release of growth factors such as eNOS (endothelial nitric oxide synthase)
3) VEGF (vascular endothelial growth factor)
4) PCNA (proliferating cell antinuclear antigen).
5) An anti-inflammatory effect
6) A breakdown of fibrous tissue
7) Stimulation of stem cells
One body part usually takes 15-25 minutes of actual treatment with the shock wave (or EPAT) therapy. The treatments are not generally painful but can be somewhat uncomfortable, but very tolerable.
Most chronic or acute pain conditions can be treated with shock wave therapy as the only treatment or an wholistic approach like this above case which I prefer and think is more effective. The fee is $150 per treatment per body part (multiple body parts treated in a 1/2 hr $150; 3/4 hr $200, 1 hr $250).
The first visit is a 60-75 minutes whether you are an established or new patient which includes a treatment within the normal office charge for that visit.
If you want to schedule a Free 15 minute phone visit to discuss your problem to see if I think I can help you with EPAT (shock wave therapy) call (916) 489-4400 or make a visit and get going. This case is indicative of how I approach people. While there is a focus on a body part I am thinking of all of you and your overall state of health that should improve as we treat your specific pain issues.
Be Well,
Kirk Hamilton PA-C
Health Associates Medical Group
Prescription 2000, Inc.
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 716-2295 (m) / (916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com