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