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Transcript
00:00So it's come to my attention that Ned from the Try Guys
00:03has a lot of problems with his knee.
00:04Being an osteopathic physician,
00:06one who has some extra training in sports medicine,
00:08I'm excited to watch this video.
00:09Let's get into it.
00:10Be whoop!
00:11In fall of 2012, I broke my knee so bad
00:14that it was cut down to the bone
00:15and my friend said,
00:17this is the day that we saw Ned's kneecap.
00:19What was cut down?
00:20I wanna know, was his skin like open?
00:22When people say break knee,
00:23I don't know if it's a fracture of their femur,
00:25their tibia, their patella, which is just the kneecap.
00:28It was plain painful in the woods in rural New Hampshire.
00:31It's something called a septic knee.
00:33I cut my knee down to the bone and then it got infected.
00:36Oh, okay.
00:37So what happens in a septic joint,
00:39you get this bacterial infection within the joint space.
00:42The knee starts swelling, it gets real hot,
00:44it gets real red.
00:45What we do in order to diagnose it actually,
00:47outside of seeing that it looks infectious,
00:49is actually put in a needle,
00:51draw fluid out and send it for testing
00:54to see the cell counts,
00:55to see if there's white blood cells present,
00:56which could be a sign of infection.
00:58We also send a culture of that fluid
01:00where we actually try and grow and cultivate the bacteria
01:03to see what type of bacteria is present
01:05and which antibiotics it could be resistant to.
01:08I had multiple surgeries to clean it out
01:10and my knee was completely destroyed.
01:13I was off work for months, playing video games all day.
01:16It got to the point where I just,
01:20taking painkillers was like the best part of my day.
01:24And it was a really, really scary time.
01:28Yeah, it's really scary because treatment options
01:30for painkillers are quite limited.
01:32You think about over-the-counter options,
01:34you have your non-steroidal anti-inflammatories
01:36like ibuprofen, Motrin.
01:37Then you have your acetaminophen,
01:39which is like your Tylenols of the world.
01:40Then after that, fairly limited.
01:43The next line is really opioid therapy.
01:45If you have nerve pain, there's some other options
01:47like gabapentin, Neurontin.
01:49And then we have like superficial treatment options
01:51where you have a non-steroidal anti-inflammatory
01:54NSAID gel, like Walterin gel, diclofenac.
01:56You also have lidocaine patches,
01:58which can help numb the area temporarily
02:01to give you healing.
02:02But long-term, we don't have great ways of pain control,
02:05except allowing your body a chance to heal itself.
02:08Oxycodone is an opioid drug.
02:12And that's one of the main factors
02:14that's contributing to the current opioid crisis.
02:17So before we were definitely over-prescribing oxycodone
02:21and this was like kind of happening
02:22during my medical training,
02:23where we started to realize that we're over-treating pain.
02:26This initially started, obviously,
02:27with the pharmaceutical companies playing games
02:29and misleading doctors about whether or not
02:31these medications were addicting.
02:33But also because of some of the surveys
02:35that we were giving patients,
02:37asked them questions of whether or not
02:38their pain was treated adequately.
02:40And doctors were seeing reimbursements fall,
02:42meaning hospitals weren't getting paid,
02:44doctors weren't being reimbursed for their care,
02:46because patients were saying, I still had a level of pain.
02:49And as a result, doctors started over-treating pain
02:51in order to get better patient satisfaction scores.
02:54But giving the patients what they want fully,
02:56100% full stop, may not actually be ideal for their health.
03:00A typical situation could be like what happened to me.
03:03You have a horrible injury, you're off work,
03:06start taking pain medications
03:08because you're actually in pain,
03:11but then you get addicted to it.
03:13So you continue taking pain medications.
03:16This isn't about the opioid crisis in the United States,
03:18this is about me.
03:19Most people stop taking them within six weeks of surgery.
03:22But here I am three months later,
03:25still taking high doses of oxycodone every single day.
03:29So at some point you need to figure out a step down approach
03:32or figure out why the pain is continuing.
03:34Is there something that surgically needs to be addressed?
03:36Is it about beginning some sort of rehab protocol?
03:39And a very interesting one
03:41that a lot of people don't talk about,
03:42taking off opioids can actually reduce pain.
03:47Kind of an interesting concept.
03:48It's paradoxical in nature.
03:50Over the last six years, I've still had lingering effects.
03:55Anytime I would bend over,
03:57my knee would pop and it would be painful.
03:59Here I am after soccer, icing my knee,
04:03and it makes me think that I'm not gonna be able
04:06to jump around and play with my kids.
04:08Is it worth it to willingly go back and get a surgery
04:14just for the potential,
04:15just the possibility of having no pain?
04:17So there's a lot of options here.
04:19There's injectable options, surgical options.
04:22I know a lot of people in the medical community
04:24like to poo-poo acupuncture and integrative medicine.
04:26I think that there is definitely some value there.
04:28I've actually had good outcomes with it.
04:30For a patient who's having knee pain of his age,
04:33it's reasonable to say maybe it's time
04:36that you don't play soccer anymore.
04:38Because there's patients of mine who are 40 years old,
04:40have had knee problems, knee surgeries in the past,
04:43and are playing pickup basketball with 20-year-olds,
04:45and are constantly having knee pain,
04:46there's times where in life we have to admit
04:48that maybe we can't do that anymore.
04:50And it doesn't mean that life is terrible.
04:52It means that adaptations have to be made.
04:54Some patients will say,
04:55I refuse for that to be the adaptation.
04:56I'd rather try the surgery and risk it.
04:58And that's totally fine,
04:59as long as they're aware of those risks.
05:06He said that everything went really well.
05:07They cleaned out all the scar tissue.
05:09He also found a minor meniscus tear, which he fixed.
05:12Meniscus, common word used.
05:14A lot of patients don't know what it is.
05:15You have a big femur bone at the top of your thigh,
05:18a slightly smaller bone, the tibia, in your shin.
05:20They sit on top of one another.
05:22In order for your knee to move,
05:23you need to have good mobility.
05:24So you have these two C-shaped pads called a meniscus.
05:28A lateral meniscus and a medial meniscus.
05:29One's on the outside, one's on the inside.
05:31And they essentially provide padding,
05:33extra stability to the knee.
05:34They actually increase surface area of the knee,
05:36so you don't have one point of pressure
05:38of the two bones rubbing on each other.
05:40I look down and my knee is swollen up
05:42the size of a cantaloupe.
05:44My thing is green, my leg is green.
05:47So here's a normal leg, here's a green leg.
05:49Okay, that's not good.
05:50I'm not sure if he's having a blood clot happening there.
05:53The swelling is very worrisome to me.
05:55That would be like an urgent ultrasound, a duplex,
05:59to see if that there is a clot forming.
06:00A lot of times when you're sedated in a surgery,
06:04you can have a higher chance of developing a DVT,
06:06which is known as a deep venous thrombosis,
06:08where the blood being stagnant in your veins
06:10because you're not moving, you're just laying down,
06:12forms a clot.
06:13The danger of it, if it gets dislodged
06:15and it continues into the circulation,
06:17it could actually end up in your lungs,
06:18block off circulation in your lungs,
06:20causing a pulmonary embolism.
06:21They said ice the out of it.
06:24So all I did for a period of five or six days
06:27was just sit on the couch and ice my knee.
06:29Wow, video games are so cool.
06:33The earlier we can get even some slight motion,
06:37post-surgically, in an area that was operated on,
06:39the better outcomes we get.
06:40And I'm not talking about him going and starting squatting.
06:42I'm talking about just gentle mobility.
06:44We actually even have patients that have robots
06:47and machines do the motion for them
06:49just to articulate the joint,
06:50just to get that fluid coming back into that area.
06:53Because the longer we leave things locked up,
06:55the harder it is to unlock them after.
06:57Oh my God, look at that.
06:59I have little tiny holes in my knee.
07:03So that goes to show he did have arthroscopic surgery
07:06because he had cameras inserted into those holes and tools.
07:08And you see that a marker there,
07:10which is weird that they didn't take that off.
07:11That just shows that they were operating on that knee
07:13before they started operating.
07:15That's how we know.
07:16You guys ready to see pictures of the inside of my knee?
07:18Yeah.
07:19You betcha.
07:20This is like the inside of my knee cavity.
07:22They have no idea what they're-
07:23These are like my ACLs and stuff.
07:25And this is a giant lump of scar tissue
07:27that they shaved away.
07:29You could have told me that these were photos
07:30of your unborn child.
07:31I'd be like, oh my God, she's beautiful.
07:33The doctor told me, you know,
07:35it'll be a week of being off your feet
07:37and then I'll be back to normal.
07:38I can help Ariel out because, you know,
07:40she's still pregnant and it'll be great.
07:42As the weeks go on, my knee doesn't get a ton better.
07:45Today, I'm going to get my sutures taken out.
07:49They kept them in for an extra couple of weeks.
07:52It got to be a weekend.
07:53There's the robot that I was talking about earlier
07:54about getting mobility back into that knee.
07:56Two weeks, three weeks, four weeks.
07:58And still I couldn't play soccer.
07:59That's not a surprise to me.
08:01Four weeks post-op, you're not playing soccer.
08:03Like, that's just the norm.
08:05I sprained my ankle.
08:06I don't expect to play soccer in four weeks.
08:08During this time, they gave me a prescription
08:10to painkillers.
08:12So here I am, exactly in the place
08:14that I didn't want to be,
08:17doing all the things that I didn't want to do.
08:19I have a prescription full of painkillers
08:22and I'm saying to them, not today.
08:28That is not the responsible way
08:29of getting rid of painkillers.
08:32There's pharmacies that will take them back.
08:32And also, if you're ever throwing away
08:34medications like that, rip your name off the label
08:37just for privacy's sake, or at least black it out
08:39just so no one else can get your info.
08:40It's time for physical therapy.
08:44Look at this guy.
08:45I love physical therapy.
08:45Resistance bands.
08:46Not wearing many clothing.
08:47You know, you can just see everything move a little better.
08:50I kept at it.
08:51Luckily, Ariel was there.
08:52Yeah, I mean, I honestly couldn't have done it
08:54without Ariel.
08:55I had the support of a great physical therapist.
08:58Kept working, kept icing it slowly.
09:02Finally, several months after the recovery process,
09:06when Wes was growing up before our very eyes,
09:09I got to play my first soccer game.
09:12Very reasonable time frame.
09:13Like honestly, when I talk to patients
09:15if they're getting major knee surgery,
09:16I would say six to 12 months no soccer.
09:19So seven months is totally reasonable.
09:22I was able to run full speed on the field,
09:25cut back and forth, kick the ball.
09:27Yes, sure, my knee buckled a couple times.
09:30Yes, sure, it wasn't perfect,
09:31but I was back to doing the things I enjoyed the most.
09:35Markiplier also has made videos about his medical journey.
09:38Click here to check out my reaction to that.
09:39And as always, stay happy and healthy.
09:41I'll see you in Markiplier's video.