Understanding Arthritis: Myths, Facts, and Management Strategies

Transcripts: 

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[00:00:00] Pete Waggoner: Hello and welcome to Beyond the Checkup brought to you by Stelli’s Health, where neighbors care for neighbors.

[00:00:08] Pete Waggoner: I’m Pete Waggoner, ready to guide you to a healthier, happier life. Today, we’re here to inspire, explore, and help you thrive in your health journey. So let’s dive right in with Brian Yost, who is going to talk about knee arthritis. A huge topic for me. I’m looking very forward to this, not personally. It’s just interesting to me, Brian.

[00:00:29] Pete Waggoner: So thank you for joining us and we appreciate you taking your time out. 

[00:00:33] Brian Yost: Thanks, Pete. You’re welcome. 

[00:00:34] Pete Waggoner: So let’s start from the top here. Can you define, explain your role as far as what you do at Stellis Health, and then what in your education and career and background led you to this? 

[00:00:46] Brian Yost: Right. So, I’m a physician assistant, and I work in orthopedic surgery.

[00:00:51] Brian Yost: So if you think of it one way, I work with an orthopedic surgeon. He and I and another PA with us, work clinic together. We do surgery together on parts of some [00:01:00] days or maybe full days. I started out in family practice for about nine years and then I’ve been 18 years in orthopedics now.

[00:01:08] Brian Yost: I just wanted to get a good background in family practice first because our boards are, you know, based on family practice. But yeah, I made the switch knowing that I always wanted to go into it. Just been very interested in it and I love it. 

[00:01:19] Pete Waggoner: So before we get into the meat of all of this, we’re going to take a quick break and have a message from Stellis Health. And we’ll get into the key components of knee arthritis and more right after this.

[00:01:30] Pete Waggoner: Are you struggling with joint pain? Discover Stellis Health’s Pain Tracker. A simple tool designed to monitor your pain and empower your provider with crucial insights for optimal care. Picture a life with more mobility and less discomfort. Visit the show notes or our website to get the guide. Say goodbye to joint pain and say hello to moving freely.

[00:01:50] Pete Waggoner: Now let’s dive back into our show.

[00:01:54] Pete Waggoner: And we welcome you back to the program along with Brian Yost and Pete Waggoner, and we will get into it [00:02:00] right now. I’ve got an overall question to arthritis as a whole. Is it something that is caused or something that is affected or both?

[00:02:08] Brian Yost: It can be both. You know, arthritis is basically, you have your bones and then you have a cartilage cap. And arthritis is that cartilage cap that just wears out. Some people are lucky enough to run marathons their whole life and never have any. And then there’s other people who inherit some genes from their parents or grandparents and things just wear out in those people more often.

[00:02:29] Brian Yost: There are a lot of factors that can cause it too, such as maybe trauma. Like when you were young, if you had an ACL tear and, or you just had one of those old injuries, you don’t know how it happened or it was in a sport, and then the knee just bothered you forever. And, you know, down the road, you end up with arthritis.

[00:02:43] Brian Yost: Infections can do it. That’s not very common. But, rheumatoid arthritis, psoriatic arthritis, those are autoimmune type disorders that can do it. Your occupation can too, like if you are on your knees a lot, you stand on cement. Age alone, [00:03:00] just as we get older, things wear out, just like our vehicles.

[00:03:03] Brian Yost: Being overweight can do it too, it puts more undue stress on the knees. So yeah, a lot of different reasons you could get arthritis. 

[00:03:10] Pete Waggoner: So, that’s intriguing. So, I think for some, who may not be as versed in it, don’t really know how this all occurs, but it’s really a breakdown, which can be multitude of reasons that occur that create this.

[00:03:22] Pete Waggoner: So, you mentioned probably, occupational athletics, overuse type things. And just aging as being, a common issue of why it’s an issue. But why do you think that, more, is it more than any other joint where that’s a problem that you’re seeing? 

[00:03:38] Brian Yost: Knee is one of the more common ones. We do see some other joints becoming more prevalent over time, such as the thumbs because of cell phones.

[00:03:46] Brian Yost: But the knees, it’s just people walk. You’re standing, you’re moving, you’re kneeling. We use our knees every day. 

[00:03:53] Pete Waggoner: I mean, and think about the pressure that we put on those too. So, how about the primary, causes? Are [00:04:00] there more risk people that may be like, I used to jump off loading docks. Because I used to deliver stuff when I first started working my radio career. And my supervisor said, I wouldn’t do that, man. I’m like, why? Cause I was like 25, and what’s going to stop me? He goes, you’re going to have problems. I mean, so, are there causes such as that, that can really speed it up quicker though? 

[00:04:21] Brian Yost: Oh, for sure. We all had, well, some still have that, thought of, invincibility.

[00:04:27] Brian Yost: Hopefully we outgrow it, but yeah we just take our bodies for granted when we’re younger. We overuse them. But another problem with arthritis is actually more of a sedentary lifestyle. You know because if you don’t have the good musculature to stabilize your knee, you have more irregular motion in the knee.

[00:04:44] Brian Yost: And even if you had no genetic history of arthritis, you can develop it yourself because of that irregular motion, because of, you know, not having good strength in your legs. 

[00:04:53] Pete Waggoner: So you brought up genetics. that was my next question. Is it genetic too, where you have a disposition where you’re just well, we got [00:05:00] to deal with it and it’s in your genes?

[00:05:02] Brian Yost: For sure. It doesn’t mean that you’re going to get it or that you’re going to get it early. Say maybe like a parent, a grandparent did, cause it’s multifactorial. You know, somebody might’ve had a very active lifestyle where they, you know, wore out their knees because of that. Where if someone else sits at a computer and works, but yet stays active outside of that, you know, isn’t overusing their joints and they might not develop it or won’t develop it till maybe at a later age in life.

[00:05:27] Pete Waggoner: So as far as progression of it, when do, and how does the typical symptoms set on and what does that progression look like over time? 

[00:05:36] Brian Yost: Yeah it, depends. You know, the symptoms are, you know, basically like stiffness, swelling, pain, sometimes a creaking or, or just, trouble, you know, with certain activities like going up or down stairs or kneeling. And it’s an onset that’s different for some people. Sometimes it comes on quickly. Someone might’ve had [00:06:00] arthritis coming on for 10, 15 years, but until they bumped their knee or landed hard on it, they really never had pain, but all of a sudden, it bothers them and it just doesn’t go away. So it’s like a light switch is turned on.

[00:06:10] Brian Yost: We see that a lot and people just can’t understand, why it can’t be arthritis. I never had trouble before last week. 

[00:06:16] Pete Waggoner: It was woken up almost when you, when you brought attention to it, right? I mean, it’s just like, there it is. Yeah. So, is it a chronic type pain? Does it exist like all the time?

[00:06:26] Pete Waggoner: Does weather impacted if it’s cold and damp? What type of things can, how does that grow and develop and evolve in a person? 

[00:06:33] Brian Yost: Yeah, the pain can come and go. Sometimes there’s a people have, let’s see if they are just moderately active, but all of a sudden they have a sudden increase in activity.

[00:06:42] Brian Yost: Like, oh, we helped mom and dad move out of the house into a new, you know, patio home and all that moving over the weekend just flared it up. And sometimes that’ll calm down with just some rest, you know, Tylenol something like that. But other times, it persists after that. And that’s kind of the, [00:07:00] onset that you know, brought it on long term and made it a chronic rather than just a coming and going type issue. 

[00:07:07] Pete Waggoner: So for those that have it in their thumbs, like you said, of the cell phones, or maybe in my case, I have it in the big toe. You can see there’s a problem there and there’s some visual deformities as far as all of that is growing on.

[00:07:20] Pete Waggoner: Can you see that in the knee or is that more of a hidden situation? 

[00:07:24] Brian Yost: No, in the knees, you can see. Like some people are bow legged or knock kneed as you would say, you know. Just because maybe the inside of the knee wears out more or the outside of the knee. Often they’re swelling, and you can’t see some physical, you know, bony type deformity, because of some spurring and just general swelling in thinner people, too, you know. They just notice that one knee just looks different than the other one.

[00:07:48] Pete Waggoner: Does range of motion get affected then? 

[00:07:50] Brian Yost: It does. Like I said, stiffness is one of the symptoms and sometimes people have chronic range of motion issues where they can’t straighten the leg out because it hurts to, so they keep a pillow under it and [00:08:00] then what do you know, they, you know, have 10, 15 degrees of loss of extension in the leg chronically.

[00:08:06] Pete Waggoner: Which is, you know, mobility matters so much, right? I mean, like, when it comes to just health and being able to move, you alluded to that earlier which is so important. And I, guess the, question I have to that the next one is, are there things or degrees of where it progresses where it could slow down or stop?

[00:08:25] Pete Waggoner: Or does it just keep going to where it’s just bone on bone type of scenario and you’re stuck? Or are there management type things that you can do personally and medically to manage and deal with it?

[00:08:36] Brian Yost: You can’t cure arthritis or you can’t stop arthritis. So once it started, it’s kind of like tread on a tire.

[00:08:43] Brian Yost: You know, if you have a little bit of wearing, it’s going to keep wearing over time, you know. Unless you have those million mile knees that never get arthritis genetically. But like I said, there’s many things you can do to kind of modify the progression of it and control the symptoms of it, [00:09:00] to get you by for many years and sometimes never get to end stage arthritis where you need, you know, a knee replacement.

[00:09:07] Pete Waggoner: So that goes to the next step. What are the therapies that occur, surgically, non surgically? 

[00:09:13] Brian Yost: Yeah, with non surgically, you try to, you know, push for that first because a lot of people can get by with arthritis and never need a knee replacement, just because you have arthritis doesn’t mean you’re going to need a knee replacement someday.

[00:09:25] Brian Yost: One of the first things is the activity modification. Like I said, if we get over that invincibility and decide that okay, I don’t have to, you know, play softball on the weekends that really makes my knees hurt. Or instead of running, you know, marathons, I’m just going to do 5Ks or I’m just going to walk, but at a slower pace.

[00:09:44] Brian Yost: So that’s one of the first things. It’s just, we have to be comfortable with modifying our activity even a little bit. Maintaining a good weight, of course, can help. Modern activity actually is very important. Like I said, you don’t want to be sedentary because you need those muscles to be strong.

[00:09:58] Brian Yost: There’s over the counter [00:10:00] medications like Tylenol, Ibuprofen. Creams like Aspirin, Voltaren, that used to be a prescription is over the counter now, and people really like that one. Prescription anti inflammatories sometimes if ibuprofen upsets the stomach, cause some prescriptions are easier on the stomach. Low inflammation diet. Vitamins, a lot of people like, omega three, fatty acids glucosamine, there’s a lot of other over the counter things. 

[00:10:26] Brian Yost: Like turmeric, tart cherry juice that people will say, or CBD. I can’t say whether these are going to work for anybody or everybody, but they’re worth a try, especially if it’s not too expensive. It’s not dangerous, and by that, I mean, you should check with your primary care provider, cause they want to know what you’re trying cause it could interact with your prescriptions.

[00:10:45] Pete Waggoner: You mentioned low inflammation diet. That kind of got me. What is that? I mean, what does that look like? 

[00:10:50] Brian Yost: Yeah, well, mainly you want to avoid certain things like, processed foods are a big one. I guess, lots of [00:11:00] carbs, you know, a lot of fatty diet, you know, things like that. And eat more things like, healthy fats, such as omega three, fatty acids, avocados, nuts, whole grains, like, quinoa.

[00:11:14] Brian Yost: I don’t mean grains, like, cause gluten can be hard on the joint, like breads, that kind of thing. But good grains, like, brown rice, quinoa, things like that are better. You know, fruits and vegetables, and get rid of the processed foods. Those are hard on the body and cause more inflammation. 

[00:11:28] Brian Yost: Some of the things to kind of cut back on the symptoms too is, heat or ice, you know, whichever helps more. Heat is good for stiffness because some people are stiff, and that just loosens them up and can make them move better, especially before an activity.

[00:11:41] Brian Yost: And then ice is good for the inflammation and pain, especially after an activity. You know, you might get kind of sore and stiff and then that can calm that down a little bit. A lot of these things also are things that, you know, you need to try before you’re going to have a knee replacement anyway, because they want you to have tried everything and sometimes insurance will cover [00:12:00] it.

[00:12:00] Brian Yost: And another thing that they do say is you should have tried to knee brace and that’s an underrated thing that can really help with arthritis. And there’s not a certain knee brace that’s perfect. There’s hundreds of different ones. It’s just maybe trying one from, you know, your local pharmacy or, Amazon or anywhere online.

[00:12:19] Brian Yost: And if that one doesn’t work, maybe trying a more sturdy one or just a sleeve. Sometimes even just an ACE wrap. And that gives a feeling of support, even if it isn’t a lot of physical support. And we’ve had a lot of people who say that really helps. And all the studies mentioned that too. Physical therapy, of course, if you have muscle weakness. And a lot of times we do prescribe that because some people just are pretty weak. And just getting some strength can help.

[00:12:43] Brian Yost: So yeah, a lot of things you can do to, you know, slow things down or just feel better, even if they aren’t permanent or a cure. Like I said, nothing can cure arthritis. 

[00:12:52] Pete Waggoner: I totally understand the idea of a sleeve and how that could work or like how that stability is. As far [00:13:00] as a knee brace, does that keep the knee then from being in a weird position, which creates more problems?

[00:13:05] Pete Waggoner: Is that kind of like straighten it out for you? Or what? What’s how does that work? 

[00:13:09] Brian Yost: There are some, very fancy braces. So if you have like bow legged knees, and it’s just that inside of the knee that’s worn down, but maybe the outside, you know, the lateral side of the knee, it looks pretty good on x rays.

[00:13:22] Brian Yost: A lot of times you get something called an unloader brace. And it will take the pressure off of that bone on bone side of the knee and put it on the side that does have good cartilage, and that can work very well. Now that doesn’t last forever because that outside is going to wear a lot more because there’s a lot more pressure on it.

[00:13:39] Brian Yost: But some people do really well with those, for, you know, sometimes a few years even, or more. 

[00:13:44] Pete Waggoner: So basically that’s balancing your tires to a degree, if that’s the situation. Sure, yep. 

[00:13:49] Brian Yost: Rotate the tires. 

[00:13:50] Pete Waggoner: That’s awesome. Okay. So then what percentage of knee replacements that you see are a direct result of arthritis versus something [00:14:00] else?

[00:14:00] Brian Yost: Trauma doesn’t really lead to knee replacement, a lot of times they say fractures. And some trauma like meniscal tears, you’ll repair the meniscus or you’ll take the loose part out or the ACL, you’ll fix that. But the knees, you know, sometimes not ever quite the same. And that does lead to arthritis and you eventually have a knee replacement from that.

[00:14:19] Brian Yost: Now, there really isn’t another reason to have a knee replacement other than arthritis. Except maybe like an infection. If you have an acute infection in the knee for some reason, that can kind of eat away to the cartilage real fast. And that still is arthritis, but it’s caused because of the infection.

[00:14:34] Brian Yost: That is really a rare thing. Gout, gout can eat away the joint and cause arthritis a lot too. We do see a few people with that. 

[00:14:42] Pete Waggoner: What is the difference between gout and arthritis? Cause I have friends with gout. And it sounds like their symptoms are very similar to those with arthritis. What is the difference?

[00:14:53] Brian Yost: Yeah, well, gout is just a metabolic disorder where it’s a purine disorder. And it’s a dietary thing and [00:15:00] diet can help control it, but it just causes damage to the joint and wears it away. It’s just one of the other things that wears away that cartilage, and keeps the joint inflamed and causes pain. So it can lead to, you know, flare ups that come and go.

[00:15:14] Brian Yost: Usually that isn’t something that’s constant. It’s something that comes and goes, like people say I had a gout flare up. You know, they go on vacation and they get dehydrated and maybe you’re having a few more alcoholic drinks that can bring on gout too. So people go on vacations and they come back and, oh my gosh, I hit a gout flare up.

[00:15:30] Brian Yost: We hear that a lot. But it ultimately ends up with, you know, if you eventually have enough of the joint that’s worn down, you might be to the point where, okay, we try all these other things I listed, and if none of them are working, then you might get to the point of needing a knee replacement. 

[00:15:48] Pete Waggoner: In ways, and it sounds like they kind of oddly mirror each other to a degree.

[00:15:52] Pete Waggoner: It’s just a different set of circumstances that get you there. Okay. I asked you a couple series of questions that are [00:16:00] just, I would say, for the fun of it. When I was a little kid, I loved to do this, you know, crack my thumbs. I still don’t have arthritis in them. Maybe I’m lucky. Is that a myth or a fact that cracking your, knuckles or bones can create arthritis?

[00:16:14] Brian Yost: I think it’s more of a myth. And you know, we get a lot of people who say, yeah, my knee cracks, listen, and they’ll crack, or snap, put your hand here, feel it, see, hear that grinding? Or feel that grinding? Or does it hurt? Well, no. Well, don’t worry about it, you know, you get all kinds of joints and things that snap and pop, and especially the older we get, but yeah, it’s not causing pain, nothing to worry about, if it is causing pain, yeah, then we need to figure out, you know, not all knee pain is arthritis.

[00:16:39] Brian Yost: It could be a meniscus tear. It could be some bursitis. Could be a strain of something, you know, a tendonitis of the patella. I mean, and that’s where we would come in and, you know, figure out what it is before we decide, what kind of a plan or if it is arthritis. Yeah. Then we discuss your options.

[00:16:56] Pete Waggoner: So I’m referring to the clicking and popping where people have, he’s checking out see, [00:17:00] what is that clicking and popping? Exactly. Oh, geez. 

[00:17:04] Brian Yost: That’s a good question. I don’t even know. I mean, it’s just noise that your tendons make sometimes snapping across things or air bubbles and just nothing related to any arthritis though.

[00:17:15] Pete Waggoner: Okay, see, there’s another one. Okay, then, are there any other myths that I haven’t brought up with those two questions, that may surround knee arthritis that you would like to debunk along the way here? 

[00:17:25] Brian Yost: Yeah, when you, I did break some down because I thought, you know, there’s some things people come in and like, oh, wow, I’ve never heard that.

[00:17:32] Brian Yost: I can’t think of any of the odd ones that we’ve heard here and there, but common ones are, if people say, Oh, I had a knee scope years ago and they cleaned out my arthritis, well, arthritis isn’t the growth that you clean out. But if someone had like a meniscus tear and you had a scope, they cleaned out the meniscus and there might’ve been like some of the cartilage that’s wearing away, it might be loose or maybe just kind of hanging like a tread, might peel off like a semi. 

[00:17:56] Brian Yost: And it’s laying all over the road. Sometimes you get a little bit of peeling like [00:18:00] that and you’ll just trim back the loose bits. You don’t have a loose body floating in the joint eventually, but it’s not something you clean out and it’s gone.

[00:18:08] Brian Yost: Like I said, it’s wearing away, not a growth. Bone spurs people. So I have bone spurs in my knee to, you know, take my bone spurs off. Well, no the, the spurring there. What it is, the knee, is growing a little spur on one bone and growing a little on the other, it’s trying to fuse it. In fact, in the low back, some people actually fuse their own.

[00:18:25] Brian Yost: They get a, because your back hardly moves much, so it actually can do it over many years. But then he won’t do that. And the spurs don’t cause your pain. They’re just a sign that yes, you have arthritis. A big one is, Oh I, I can’t exercise, you know, my, I have arthritis and well, no, you actually need to have some exercise, moderate exercise actually. 

[00:18:45] Brian Yost: I’ll say 30 minutes of moderate exercise, three times a week. And moderate is different for a, you know, a 20 year old than it is an 80 year old, of course. It’s important to keep those muscles strong. That’s a another big myth. You’ll cure for arthritis. [00:19:00] Some people, you know, well, yeah, I found this thing online.

[00:19:02] Brian Yost: It says it’s going to fix my arthritis. Should I try it? Like I said, there’s nothing that can cure it. It’s just, how you control it or manage your arthritis. 

[00:19:12] Pete Waggoner: I’ve heard about, and I don’t know if this is even a thing. Is there some sort of gel that’s infused in some instances that mimics cartilage or does, is that a thing?

[00:19:22] Brian Yost: So there’s a two different answers to that. I’ll start first, like in clinic, when people come in and if they’ve tried all these options, you know, one of the things we commonly do is a steroid shot, which gets rid of the inflammation. You know, but there’s still the grinding and then eventually that’s going to lead to inflammation down the road. Whether it’s Oh, as bad as maybe just a few weeks, or maybe it’ll last as long as a year or two.

[00:19:43] Brian Yost: And then there’s gel shots we do. People might call them rooster coom shots, chicken shots. But anyway, it’s called hyaluronic acid, which is actually the lubricants in all your joints. So your eyes actually have some in it too. So it’s something your body makes, but it just, you [00:20:00] get kind of a thin, watery fluid in the knee and it’s not thick and viscous and lubricating.

[00:20:04] Brian Yost: So those gel shots just put more of the lubricant back in the knee. Kind of like an oil change really is kind of the way I describe it. Now when you talk about a different gel that there’s, like you talk about advances in knees, you know, what’s happened over since I’ve been out of school the last, you know, 25 years or so.

[00:20:22] Brian Yost: And there’s a lot of different things that have come and gone, and not a lot of big groundbreaking things have happened. One is they talk about putting like a pad in there, you know, to cushion the knee when it’s arthritic. You know, there’s always infections concerns with that and the body breaking it down, it just wearing down real quickly.

[00:20:39] Brian Yost: And, you know, you can’t go in every year and have something like that put in. Cartilage transplants, that is not a great option either. And once again, rejection or just lining things up, right, that’s not a great one either. One of the biggest things I think that has come around in the, say, in the last, you know, decade or so is a robot guided knee replacements.

[00:20:59] Brian Yost: [00:21:00] It’s quite expensive, not to the patient, but it is quite expensive medically. The argument is that for using it is that, it can cause less bleeding, gives you more accurate cuts, and a faster recovery. But if you look at, let’s say, six weeks to six months down the road, there really isn’t, there aren’t any good articles showing a statistically different result in outcome, like, how are you doing down the road?

[00:21:25] Brian Yost: One argument for like, down the road is that, okay, can the knee come loose because the cuts weren’t so accurate? There aren’t even any great studies showing that the knees are more likely to come loose if you have somebody do it just with, you know, templates that we have set or guides to make our cut rather than using a robot. 

[00:21:42] Pete Waggoner: Brian, people can’t see me on this podcast, but I have my hand over my forehead.

[00:21:46] Pete Waggoner: And I’m thinking about like, if there’s no way I would ever have a robot doing anything. I just, I mean, it’s kind of crazy when you think about it, because, humans are humans. And obviously, but I just think my faith and trust in [00:22:00] your, profession is so high. And your group does this so often that no robots here anytime soon. I’ll let someone else experiment with that over there, but, you know, is there, an age, where you say, maybe this is getting a little too late in life to do, or do you guys just say, no, we can go forward with anybody?

[00:22:20] Brian Yost: No, there is a point where you get somebody who maybe has like medical problems, like they have a bad heart. You know, they have congestive heart failure and you don’t want to cause some swelling with a surgery and fluid overload them and then they have a heart attack. Or they just have a bad heart, can’t have bypass, and they’re a high risk. Or someone with a bad lungs, like really bad COPD and they are on oxygen, you know, sometimes that’s really risky.

[00:22:47] Brian Yost: And then you also get people who are older or very frail and you realize that, you know, they’re just not going to do good with therapy. They’re not going to be able to do the therapy and they’re going to have a net loss of [00:23:00] function because of the surgery. So you, you just try to manage them, you know, in other ways, if you can, you know. I mean, everybody wants to at least have some bit of independence, especially if they’re living at home and that’s the hard part, trying to keep them independence without having a surgery, you know, for the pain they’re having. 

[00:23:20] Brian Yost: So yeah, that’s where we just, we have the injections and you’ll try some different things on them. You might recommend some more of these alternative diet things or medications. Like this CBD or, and really they can try anything.

[00:23:32] Brian Yost: Like I said, as long as it’s not dangerous or going to interact with their medications and it doesn’t cost them an arm and a leg. 

[00:23:39] Pete Waggoner: So, this all comes back to something you, mentioned earlier. Strength, I think if you hear that theme a lot with everybody I speak to, and having some sort of muscular support within your whole systematic body. No matter your age, no matter what you can do, to do some sort of strengthening [00:24:00] exercises in your home or whatever you’re doing, sounds to me like it’s really important, so you don’t get frail and things. I mean, there are other circumstances that lead to that. But so it’s not so important to me. Is that a fair assessment? 

[00:24:12] Brian Yost: It absolutely is. Yep. Yeah. Your knee is supposed to bend in one motion, just front and back.

[00:24:18] Brian Yost: And if you have weak muscles, there’s this little micro motion side to side and in a little bit of different directions that just causes more of the grinding and sometimes people only have it like behind the kneecap. And then they just can’t go up and down stairs because when you bend, you know, that grinds a bit more. And you really need the muscle strength, the more arthritis you have.

[00:24:39] Brian Yost: So, if your leg feels like it’s going to give out, like some people say, why does my leg give out? Well, that’s when the bone kind of catches a bare spot and grinds on another part of bone. You have to have some muscle strength to keep yourself from falling. Because that’s another risk, you know, you fall with.

[00:24:53] Brian Yost: Some of these things, and then all of a sudden you’ve, you know, fallen on your shoulder and got a, an arm fracture or a rotator cuff [00:25:00] tear to go with your bad knee. 

[00:25:02] Brian Yost: Then you can’t use your cane or your walker that you had been getting by with, you know.

[00:25:06] Brian Yost: That’s another thing too, assistive devices. Some people are, so Adam, it’s about, Oh, I’m not going to use a walker. You know, you really need one to prevent a fall, or if you really want to go out and about, and you don’t want to have surgery, or you don’t want to try some of these other things or therapy or whatever it might be that could help you.

[00:25:22] Brian Yost: You need to use the walker and, you know, put the humility aside. I have relatives, direct relatives that, you know, sometimes waited too long to use those things and had a fall and, and then begrudgingly, Oh, okay, fine I’ll use one. 

[00:25:36] Pete Waggoner: I’ve seen it with loved ones myself. And just so proud and nope, I can do this.

[00:25:42] Pete Waggoner: And then you see the fall and then you see the after effects of it. Because I think it’s important as we get older, if your knee gives out, when you’re little, you know how to fall. And, or I don’t know if you know how to fall. You just, you’re like Gumby. You just pop right back up and off you go.

[00:25:57] Pete Waggoner: But when you get older, I don’t think it’s, there’s [00:26:00] anything natural about it. And it’s just acknowledging that that’s, that’s where I’m at, right?

[00:26:05] Brian Yost: Right. Bumbles bounce. We’re not bumbles. 

[00:26:08] Pete Waggoner: Yeah, exactly. How many steps do you think, I mean, this is a crazy question. From infancy to death, a person would take, I mean, it must be hundreds of thousands, maybe millions?

[00:26:22] Brian Yost: Oh my Lord. You could say, you know, if you’re, you look on your Apple watch, you’re supposed to get 10, 000 a day and a lot of people, Oh, I only get 4, 000 a day. We multiply that times three 65 in a year. It’s times a lot of, yeah, I don’t know, it’s millions. I’m sure. 

[00:26:37] Pete Waggoner: That’s how much your knee is used. I mean, that’s incredible.

[00:26:40] Pete Waggoner: And the, the, just the pounds of pressure that are going on there. I mean, it’s pretty incredible how it all works and that you, as an organization, at Stellis Health, are able to assist people in this situation, to make things better. I’m sure you have some success stories where when people are, fixed, so to speak, they feel [00:27:00] 10 times better.

[00:27:00] Pete Waggoner: I’m sure you hear stories like that. Have you had any good success stories? 

[00:27:04] Brian Yost: Oh, absolutely. You hear a lot of people saying, Oh, why did I wait so long? You know. You know, people don’t realize that they figure, Oh, I’m just going to get my knee, you know, and you talk to Uncle Ted, who says, Oh, it was great. I did great.

[00:27:17] Brian Yost: And maybe Uncle Ted is a very active guy though. And then why am I not doing as well as Uncle Ted? Or, well, it could be the opposite though. Uncle Ted complains about how bad it was, but he was a very sedentary guy too. So don’t trust uncle Ted necessarily, especially when he’s telling you what to do or not to do, or pick up this magic potion on Google.

[00:27:37] Brian Yost: You’ll Google it and get it. It’s great. You really need to be careful and you know, we’re glad to help you decide what to try, what not to try, and give you some options at least, if you’re struggling and not managing your arthritis on your own. 

[00:27:51] Pete Waggoner: When do you think people should come see you?

[00:27:54] Brian Yost: When your activity is hampered more than you [00:28:00] want. Some of us can cut back, let’s say maybe 5 percent or 10 percent or do a little bit less of this, but when you’re cutting back 50%, 70, 80 percent of what you want to be doing, okay, it’s affecting your lifestyle too much and something needs to change. Or you’re going to get depressed or overweight. You know, just, it leads to more of an unhealthy lifestyle in general if you can’t be mobile. 

[00:28:22] Pete Waggoner: That is, well said there. And, this has been a, I would say a wide ranging discussion, which I’ve really enjoyed. Before I wrap this up, is there anything that we have missed that you feel is important to share with the listener? 

[00:28:36] Brian Yost: No, I think we, covered some things back and forth a little bit here and there, but we hit it pretty well.

[00:28:41] Brian Yost: And, if people have questions, you know, we’re more than happy to answer them. And if you found something on Google, and you’re wondering if it is something good, yeah, we’ll be glad to tell you if it’s something you could give a try or not. 

[00:28:53] Pete Waggoner: So you can be the fact checkers to people’s Google searches, right? No, that’s great stuff. So. Thanks for joining us. [00:29:00] I found this really fascinating. I appreciate your time here today. 

[00:29:03] Brian Yost: You’re welcome. Thanks, Pete.

[00:29:04] Pete Waggoner: That’s a wrap for today’s episode of beyond the checkup brought to you by Stelli’s Health, where we believe in neighbors, caring for neighbors.

[00:29:10] Pete Waggoner: I’m Pete Wagner. Thank you for joining us on this journey to better health.