Jul

12

Medicine By Trial And Error

Posted by cameron

July 12, 2007 |

I have had a couple of experiences that leave me wondering where the science is. The first was a knee problem that required arthroscopic surgery on both sides of the knee. This was determined after x-rays etc to be torn menisci for which stitching and clipping were deemed necessary. After about a week or two of therapy I was beginning to think that one of the painful problems was still with me. I was told they couldn’t be sure until they were inside my knee. As time went by I became more certain that pain was still with me even though a couple of my symptoms had gone. I mentioned the pain to my surgeon who promptly told me I needed to give therapy more time. Time went by with no change. I raised it again with the surgeon who then said, “If this doesn’t work then we could always replace the knee”. Of course that kind of answer left me stone cold in my certainty that this surgeon would not be doing anything of the sort. Not in this lifetime. We’ll try this and if it doesn’t work we’ll try something else.

The second experience is with the Prostate. OK my PSA had risen and that led to biopsy, which found nothing but an infection. The biopsy is where they stick a matrix of needles into the Prostate and withdraw small pieces of the material to study under a microscope for cancer. If the cancer is small enough to fall between needles it is undetected.

Many things can cause the infection but it can also elevate the PSA score. So deciding what exactly is going on becomes trial and error. A series of antibiotics may or may not kill the infection so we try this and we try that. The annual physical, which started all this is clearly the right thing to do but I sometimes wonder why we aren’t good enough to get right to the answers.

We are advanced in the diagnosis of the existence of a problem but getting to an answer and cure seems to be lagging. Maybe it’s a lack of fundamental understanding of causes that lies at the heart of the problem. This was amplified to me when I searched the web to study infection in the prostate. The more I read the more I realize how little we truly know.


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