THE PHYSIOTHERAPIST AND THIRD DOCTOR.
The very different diagnosis by the two doctors raised my ire. I determined that I would learn all possible about joint diseases and their treatment. At the same time I saw a very good physiotherapist at a local clinic who had been treating my wife for back and knee problems. She did a very thorough examination of both of my shoulders. She determined that they were down to 50% mobility and said that I had reumatoid arthritis. She thought that about the only thing that would help would be cortisone. She gave me some gentle exercises that would help to keep up the muscle tone.
I saw the third doctor on Sept. 8th.,1995. I was well armed with knowledge on arthritis and all of the various treatments that had been used over the decades with very little success as a cure for arthritis but with considerable devastation from side effects. In addition I had carefully studied the hormonal systems in humans in regard to their purpose and very delicate balance. I particularly studied all possible about cortisone and the history of its use over the last four decades.
The doctor that I saw was very interested in sports and does a considerable amount of work with damaged joints. I thought that he would be well versed in using cortisone. He gave me a very thorough physical including a carefull exam of my shoulders and knees. He requisitioned a number of X-Rays of my knees and shoulders. In addition he called up a number of blood and urine tests including a sedimentation blood test. This test when it proves to be abnormal usually indicates arthritis in the body. Mine turned out to be abnormal. It was 39 when normal is 20. I had thoroughly read Gray's Anatomy on knee and shoulder joints and was quite surprised to read that in Gray's time bacterial infection such as TB was quite common in joints.
Afer several visits the doctor decided to give me a shot of corisone in the right knee. I suggested that a sample of synovial fluid should be extracted before the shot of cortisone to check for bacteria and other foreign substance. The synovial fluid is the natural lubricant in the joints along with a thin layer of cartilage between the articulating bones. All tests proved to be normal except the sedmintation test. The synovial fluid was clear of any foreign substance and bacteria. The X-Rays indicated some loss of space in the joints but this is normal with inflammation. X-Rays are notoriously useless in finding irregularities other than those of the bones except when some opaque substance is used such as barium. MRI scans are vastly superior but in Canada priority is given to professional athletes who usually are given an MRI the next morning after they are injured and this procedure is well publized on the sports programs on TV. The Canadian Health Act calls for equal access for all citizens but second class citizens like my wife and I never get close to an MRI. We usually have to wait six months to see a specialist and another six months to get a simple arthroscope which is done without an MRI diagnosis.