M.D. Or D.O.?

[cabinetman]

About 6 weeks ago I started to have extreme pain in my left knee. I can hardly walk. I don't remember any trauma. Maybe too many jumps and hard landings. Could be just a degeneration due to work load. But, I gotta say I have a very high threshold for pain, and this is a 10.

I got a few referrals to a local orthopedic surgeon, that's a D.O. Growing up I got the impression that serious conditions should be treated by M.D.'s. My father called D.O.'s "naturalpaths". I looked up the differences and similarities, and it appears that D.O.'s are qualified to treat physical conditions like mine. I need to make an appointment pronto.

So, what I'm asking is what are your thoughts here on this question. Have any of you been treated for anything serious, or had surgery by a D.O.?
.

[leehljp]

I am in Japan and can't speak of the MD vs D.O. difference.

I will tell you that one year ago I had a similar experience and even got my medical carrier to contact the hospital to let me have surgery.

The Orthopedic Surgeon did an MRI and there were several items in my knee that reflected the need for surgery and even a knee replacement. However, being in Japan, the doctors rule and the patients don't question the Doctors, period. I went to a sports doctor and several in the international community here recommended him. But since I was within a year of returning to the States, both he and my US Doctor urged me to do what I could to wait until I returned to the States for surgery.

In the mean time, the Japan doctor gave me injections - 2 the first week, and one each week for 4 weeks and then every other week for 3 more weeks. Then "joint" tablets daily. I have made it a full year. I am afraid to "jog" and I can tell after walking a couple of miles that I should not push it anymore than that. I really miss the walking exercise that I used to get in work. It has slowed me down. I don't jump around like I used to either.

My point is that if immediate surgery is not needed, shots and joint do a lot to eliminate the pain and buy some time until you figure out precisely what you want to do.

I forgot to mention knee braces. At the same time I had my problems, a friends wife had a similar situation in Kyoto, about 100 miles from here. My doctor recommended that I get a simple stretch wrap around knee brace with a simple hinged aluminum brace on each side. I wore it under the pants and there was a slight bulge. My friends wife had one of those that cost nearly a thousand dollars and wore it outside of her pants. At first I thought that it was a better one, but listening to her talk about the difficulties of putting the complicated one on, and taking it off, how hot it gets, I was glad that I had the simple one. I did use a cain for about 2 months.

[cabinetman]

In the mean time, the Japan doctor gave me injections - 2 the first week, and one each week for 4 weeks and then every other week for 3 more weeks. Then "joint" tablets daily. I have made it a full year. I am afraid to "jog" and I can tell after walking a couple of miles that I should not push it anymore than that. I really miss the walking exercise that I used to get in work. It has slowed me down. I don't jump around like I used to either.

My point is that if immediate surgery is not needed, shots and joint do a lot to eliminate the pain and buy some time until you figure out precisely what you want to do.

Thanks for the response. I think I got some shots like that a few years back. I had severe tendinitis in my hands, and went to an M.D., to see if I had R.A. Well I didn't have R.A, but got some cortisone shots in the finger joints. I could only get three separate treatments, as they said it affects the immune system. They did work pretty good for that, while it lasted.
.

[jking]

Maybe in the past D.O.'s were quite a bit different than MD's in their training, I don't really know. Where I am, we have a medical school that is all D.O. schooling so there are quite a few D.O.'s around. They work in the same clinics as M.D.'s with no apparent restrictions to what they are allowed to do. Both of our sons were delivered via C-Section by a D.O., who is highly thought of & he did a fine job.

I would suggest making sure you get good recommendations on your surgeon & make sure you're comfortable with him/her & the answers given to you. I don't think MD vs DO will matter.

[Rich P]

Don't know the difference personally but from what I have heard the best test of a positive outcome is to ask the question "How many procedures like mine have you done?".

[Ed62]

My wife had problems with knee pain. She could only walk about 20' or so, then had to sit.

Her doctor told her about what he called WD-40 for knees. It was synvisc, and it consisted of an injection once a week for three weeks. He told her not to expect more than a year of relief, if that much. It has been about 4 or 5 years since she received the shots, and she is still doing pretty well. But that result is not typical.

Apparently there is now a one time injection. Here's a little information on it. http://www.synviscone.com/about.aspx Good luck.

Ed

[cabinetman]

Don't know the difference personally but from what I have heard the best test of a positive outcome is to ask the question "How many procedures like mine have you done?".

Don't laugh (well, you can if you want), but I had foot surgery in the Army performed by a young Captain out of medical school. He performed a (then) new procedure. I didn't have much choice being part of his learning curve.
.

[germdoc]

Some of my best friends are DO's...

Seriously, my sister went to osetopathic school in Des Moines. There training is similar though not as rigorous academically, except for the emphasis on chiropractic-type manipulation. Most DO's who do a standard residency abandon the manipulation for traditional scientific treatments.

When I was at Mayo they would not accept DO's as medicine residents, but that has since changed.

Bottom line: look at where they trained. A DO who trained at a reputable place would likely be of good quality. Then do what I do: ask as many medically knowledgeable people who they would want for their doctor. Nurses, especially, don't mince words about whom they do and don't trust.

You may not like my next bit of advice, which is to avoid surgeons if at all possible, because what's cut can't be uncut...

[MilDoc]

I agree with germdoc. Assuming a DO finishes a good residency and training program in ortho, no problem. The real meaning there is "good" program.

Ask where they trained (basic residency and specialty), then if they recommend surgery, ask how many such procedures they have performed. Then ask what their post-op infection rate, and their success rate with that surgery is. Any good surgeon should be able to answer questions like that and not be offended.

There are good an bad docs no matter what the letters after their name.

[Rich P]

Well, at least your GI doc didn't stick you with a big medical bill!

However, I would imagine some procedures are like hand cutting dovetails...the more you do the better they look.

FWIW, I know a "later-to-be" RN who previously worked in a PT place with a guy who kept trying to get into medical school but was rejected and then finally got into a school to become a DO.

As germdoc says above, to paraphrase the old adage, "If all you've got is a scalpel, everything looks like it needs surgery".

Sounds like you are in some serious pain so please accept our sympathies and best wishes for a speedy and successful outcome, whatever course of treatment you decide on.

[cwsmith]

My wife and I used to go to a "Doctor of Osteopathy" many, many years ago. He was quite prominent in our area and was highly recommended.

I don't know where I got the impression from, but I've always been of the understanding the a D.O. was both medically trained in the general practitioner sense, as well as educated in bone and muscle structure similarly to a chiropractor, but with additional training. Our doctor could and did prescribe medicine as a normal doctor would and in addition, he was also the county coroner at the time.

What led us to this doctor was that my wife had suffered a rather painful neck injury in an accident. She had seen two local doctors who had given her heavy pain prescriptions. When that didn't help, she was referred to a neuro surgeon who had then started giving her injections and was pushing her hard for surgery. (At the time, we considered that quite risky.)

A friend recommended that we see this particular D.O.. After a lengthy interview, and reviewing her medical records he pronounced that she was "on the local medical merry-go-round. He examined her neck and told her he could feel that the structure was out of alignment. He slowly took her off her pain prescriptions and prescribed something significantly milder. Then through manipulation, rest, and then later an exercise program, she was like a new woman over the next month or two. That was about thirty years ago and she hasn't had any reoccurring pain.

I hope this helps,

CWS

[MilDoc]

However, I would imagine some procedures are like hand cutting dovetails...the more you do the better they look.

Absolutely true. cabinetman for example is a much better woodworker than me. Experience counts!

"If all you've got is a scalpel, everything looks like it needs surgery".

That's the "Cut To Cure" philosophy. But a good, reputable surgeon does not subscribe to that.

IF surgery is recommended, I'd get a second opinion.

What bothers me is the sudden acute onset of pain with no recalled history of trauma. If you were a teen, there are at least 10 exam tests I'd do first. Then possibly (probably) a knee MRI.

[TB Roye]

My Cousin stitched me up once when I was injured while working for him at his hospital.

He had DVM behind his name. Accidentally cut myself on a Scalpel while helping him spay a dog. 6 stitches in the palm of my hand, I told him fix it. Shot of Novocaine and off we went it wasn't that deep just would never have been able to keep is closed with a bandage. Had his intern finish the dog at one end of the table and me sitting at the other end. Probably could have gotten him trouble. Had shot of antibiotics form a MD friend of his the scare is hardly noticeable now almost 50 years later. Kind became a joke around his circle of friends in later years, we still tell the story to the younger member of our family.

Tom

[Kristofor]

What bothers me is the sudden acute onset of pain with no recalled history of trauma. If you were a teen, there are at least 10 exam tests I'd do first. Then possibly (probably) a knee MRI.

And if he were a horse they'd shoot him, let's hope for something closer to your approach!

I believe my only experience with a DO was related to a football injury in high school. I was far from thrilled with that particular set of interactions with that particular doctor, and would never go back to him... On the other hand my grandfather, who ultimately had both knees and hips replaced (over a couple decades), liked this particular doctor quite a bit.

What does that say about the degree? Probably nothing I guess...

[billwmeyer]

My family went to a DO in the Tulsa, Ok. area years ago. We never had anything serious, just the normal colds, etc. He was great. When we moved, I wish we could have taken him to the next town.

Bill