Yes, you DO have to ‘live with it’, and that can be a good thing

A common ending to a consultation where I have explained to a patient that there is nothing that surgery/medicine can reliably or safely offer them for their symptoms (back pain, joint pain, limited joint movement etc.) is “So I just have to live with it do I?” A difficult question to answer but also a question that tells us a lot about the person asking it.

The wisdom of wisdom tooth extraction

I have 4 kids, 3 of whom had their wisdom teeth removed on reaching adulthood on the advice of specialists. I had mine removed in my 30s for some reason and so did my wife. In the US and much of the world this is a billion dollar per year business, with millions of molars extracted every year in the US alone. With those numbers, even a small complication rate can add up to a lot of complications, and as a surgical procedure there are also significant costs. Yet it has been argued that the reasoning behind most of the extractions are flawed and that the procedure is often unnecessary.

2 ½ litres of water per day - really?

Many people I know drink water constantly – they are always taking a swig out of a water bottle that never leaves their side. After having renal stones recently, I tend to try to drink more, but just don’t like drinking water, and I find that I am not thirsty most of the time anyway. Who’s right – those who tell me to drink water constantly, or my body, which rarely makes me feel thirsty?

Treatment for pre-term rupture of membranes in pregnancy

Another large international trial is published, and another standard practice based on little more than our bias towards doing something rather than doing nothing is reversed.

Book review, of my book: Surgery, the ultimate placebo.

This will be a test of how unbiased I am. Writing a review of my own book (regardless of any bias) seems like shameless self-promotion, but what the hell, it's better than just saying "Hey, I wrote a book".

Knee arthroscopy for "mechanical symptoms"

I have previously written about the (non) role of arthroscopy for osteoarthritis or degenerative meniscus tears in the knee (here, here and here). Surgeons have continued to operate, based on a belief that (now) centres on the presence of mechanical symptoms. An analysis of the recent sham surgery trial of arthroscopic partial meniscectomy (APM), which showed APM to be no better than sham for patients with meniscus tears without arthritis, has shown that this procedure is no better than sham surgery for patients with mechanical symptoms.