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Show Ctee MM Ds yirasttfflBBDe By WILLIAM J. GOLDWAG, M.D. Copley News Service Q. I tore the cartilage in my knee while playing tennis six months ago. I had to have an operation and they took out pieces of cartilage. THE DOCTOR said that after the operation my knee would be as good as new, but it's now four months since the surgery and it still swells up and doesn't feel normal. Do you think something else could have been wrong? Will more X rays show why I'm still having trouble? I'M AFRAID to do any "xarcise because if the same thing happened to the other knee I would practically be a cripple. Is (here any way of prevnting a cartilage tear? The most common cause foi piu'nnged recovery from knee surjerv is insufficient nhMinh. rap This means .on iv i-d to lestore t he normal nor-mal protection that muscles prmnle toi theJsnee joint. THfc KNEE joint is basically a very unstable joint. The bones are kept together by tough ligaments and a joint capsule that -rounds the joint. ven though "game s are tough, they are ..ot very elastic elas-tic so the can't be stretched or twisted without tearing. Thp powerful muscles and tin 'Ci.. ms which -! the fro ant. .jack of the knee are its majti: protectors. Any we;ikne in these muscles allows more strain to be traismitted to the rigid tissue tis-sue . like the ligaments. the CARTILAGES be veen the ends of the bones an : .ached to the ligaments so Miat certain kinds of twists exerting their pull on these lig iTients may tear the cartilage car-tilage II is normal .for the joint to sw II after the operation and fluid will rearcumulate with walk'nc for a number of weeks after surgery but ventuallv il- stops. As soon ,., . ,-ihie exercises must be -started again and kept up. THE MOST important muscle is the quadriceps which is the large bulky muscle composing most of the front of the thigh and attaching at-taching to the kneecap by a strong tendon. This muscle functions almost every time the knee is bent. By sitting on a table and lifting the lower leg until it is straight out horizontal, this muscle gets its best exercise. Doing this 15 to 20 times twice daily restores tone to this muscle. By adding weights to the foot, one can then get strength in the quadriceps and bv the time you are lifting 30 to 40 pounds of weight 15 to 20 times twice a day, you will have a well protected knee 'ioint. IT MAY take six months to a year to restore normal function to the knee but it is far better to do it now than to risk new injury. This same exercise will protect the other knee against all but the most extreme types of motion experiencpd in most sports. Tennis, because of the frequent twists of the body while the foot is fixed to the ground gets to be a particularly par-ticularly hazardous sport with regard to the knees and requires more conditioning than most people achieve. Q. MY grandfather is 76 years old and has always been "in good health except for a cigarette cough. He has coughed for as long as I can remember. Abut three months ago he started to cough up some blood not a whole lot but little clots of it when he coughs really hard. I TRY TO get him to go to a doctor but he absolutely refuses, just says it's from straining hard when he coughs. Of course, he won't stop smoking either. I realize there's no way of knowing exactly what's wrong but 1 read so much about cancer and I'm afraid that's what he has, I know he'll never have an operation. IS IT pnssihli 'I,... ii is ..iiv from si ruining? A. 01 course it's possible but rather unlikely. Blood vessels don't break that isily in that location unless they break in other ar as also, or there is a bleeding tendency frm something afheting blood cloning In those cases bleeding Irorp the gums is common nd even in your grandfatl -r is possible especially his gums are infected, in-fected, inflammed or abnormal abnor-mal in any v ly. BLOOD FROM the nose or sinuses can also drip down into the larynx and be coughed up. Growths on the larynx can bleed but more commonly cause hoarseness also. There is a wide variety of ailments of the lung associated associat-ed with coughing up blood but the more frequent ones in his age group and smoking habit includes tuberculosis, bronchiectasis, emphysema and tumor. Tuberculosis, although less common than years ago is not unusual especially es-pecially in the older age group. Sputum tests will help greatly in determining if this is present. Bronchiectasis is a condition condi-tion in' which infection in the lung destroys some of the air sacs and results in widening of the tiny bronchial tubes and tendency to produce a lot of sputum often with blood, and small infected areas of lung and scar tissue. EMPHYSEMA results in stretched, ballooned out air sacs and causes shortness of breath as its major symptom. Malignant tumors are more common in smokers and are also a strong possibility. X-ray of the chest would help greatly in pointing to one or the other although it might not give any definite answers. Without some tests to know what treatment to give but for whatever comfort it gives, there are other possibilities besides cancer. FOR THE protection of others he comes into contact with, some simple tests to rule out tuberculosis would be essential especially if small grandchildren are ever around. |