Kazuo Takayama writes:
I suspect that patient Yoko Kashiwagi has osteoarthritis. My reasons:
(1) She is 42 years-old. (Osteoarthritis usually begins after age 40.)
(2) She said that she had been finding it increasingly more difficult to move her left knee. (Osteoarthritis usually develops slowly.) (3) She has pain in one part of her body: only left knee. (Osteoarthritis usually affects only one side of body.) (4) She complained of cracking, stiffness and swelling and redness in her left knee. (These are all symptom of osteoarthritis.) But I'm lacking data to pass diagnosis of osteoarthritis. I want more information. Firstly, I don't know how bad her left leg is. I would like to take X-rays of her affected joint, since X-rays can show bone damage (and if the affect is caused by osteoarthritis). And I will take a sample of her blood or fluid withdrawn from inside the affected joint. These test results will lead me to suitable diagnosis. Secondly, I would like to know whether her daily work is hard or not. I'm not familiar with the mass media work, but I feel it is hard. If it is so hard, she must change her work style on the recommendation of my advice. In addition, if the office in Tsukiji is quite a distance from her home in Denenchofu (I don't know how far Tsukiji is from Denenchofu), the burden on her knee may be too heavy. Thirdly, does she have allergies to any medication or not? If she has allergies, I must pay attention to choose medicine for her disease. Finally, is she taking any medications or not? Some medicines that are fine to take alone can cause a harmful reactions when they are taken with another medicine. If she is taking another medicine, I would like her to report the medicine name to me.
If she is osteoarthritis (there is a possibility that she has osteoarthritis), I will create a form of treatment for Kashiwagi. But there are several general types of treatment for osteoarthritis. Basically, beginning treatment as early as possible can help reduce long term damage to joint and bones. There is no doctor who can cure her sickness, may be. But I will do the best I can do. Firstly, I would like to advise her to lose weight. Overweight is one factor that causes cartilage to go bad. And there potential side effects of many drugs that are used for treating osteoarthritis, so medication is usually recommended only after weight loss. I heard she had gain 7 or 8 kilos since she stopped exercising. First of all, she should take moderate exercise again. But not running, because the burden on her left knee is too heavy. It is good for her left knee to swim, I think. Swimming is the best exercise for diet, as well. Moreover, swimming lightens her knee's burden of gravity. Next, she might benefit in making use of a crutch or a wheelchair if possible. She may have to consider, furthermore, an operation, if she continues tofeel severe pain in her knee. But surgery could cause inconvenience to her. This is an especially important problem to her since she has a responsible business. I will keep this means as a last resort. Finally, I should treat her by medication in long-term to reduce pain and stiffness, allow for great movement, and slow the progression of the disease.
Osteoarthritis cannot be cured. It will take a lifetime to treat her with osteoarthritis. So the disease is, so to speak, her partner, Kashiwagi should learn about osteoarthritis and must charge her life style. For example, she should stop working hard and going to office over a long distance. Using a cane, crutches, or walking regularly or whenever she needs to can help reduce strain on her knee, and she should not squat or kneel. But life style changing is very stressful to her. It is very important that osteoarthritis be accepted by her. That is why she should be optimistic. It is certain that osteoarthritis cannot be cured. But it is too early to give up hope. If you give up thinking of healing her disease, it may progress badly. The disease can make her feel angry, sad, irritable, or afraid. These feelings can be overcome by those who care for her: family, friends, a lover. So it is necessary for her treatment that we establish the health care team composed of doctors, nurses, physical therapists, social workers, psychologists and family, friends, etc. Osteoarthritis is not only cured by the patient alone, but also the health care team. Ms. Kashiwagi should not give up hope. We will try to fulfill her wish.
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