Everything Changes with Time

By: Dudley Phipps, PA-C, CCD, FLS

In 2006, my wife and I purchased a Toyota Sienna minivan.  Looking at vehicles, this certainly wasn’t one of my favorite choices.  After some debate, we ended up with the van.  It turned out to be a great decision.  We made hundreds of trips to family and sporting events, mostly chasing our teenaged children to events.  It seemed like the further we drove for the kids, the more of “not our kids” we’d end up with on the ride home.  We’ve created some great family memories in the van.

Fast forward to today.  The van has almost 250,000 miles on it.  I’ve noticed as the mileage increases, so does the need for routine maintenance.  Not only that, things break down as they wear out creating new levels of challenges.

I’m sure by this point you’re completely engrossed in my rants of family transportation, but this makes me think of my work passion – bones and joints.

Here’s why – when you are young, nobody thinks of their bones and joints.  Although most of the musculoskeletal system is running in hyper drive up to the point of skeletal maturity (between 20 and 30 years old),  nobody, neither providers nor patients, give it much thought.

In your youth, there are typically very few problems with the skeletal system.  An occasional crash and a broken bone, but no real wear and tear items.

As you have more birthdays (i.e. more mileage), the wear and tear start to show.  Cartilage begins to show signs of wear and tear, the dreaded onset of osteoarthritis.   The New Year’s resolution of more exercise brings to light that the muscles, tendons, and ligaments are not 18 anymore.  It takes longer to heal than it did when you were a kid.

More birthdays, joints begin to feel like you are breaking a rusty wheel loose in the morning.  The jump out of bed is now a crawl for the first few steps.

More maintenance.  Daily pain is now a frank reality.  Joint replacements that you thought were for “old people” are now on the shopping list.  Dreams of replacement knees, hips, ankles and shoulders all shine like constellations in the clear winter sky.

More birthdays, osteoporosis begins to set in.  It’s been happening for years, but a lack of routine maintenance has now made it a major overhaul.  This painless, almost symptomless disease can be the foreboding of catastrophic life.  The most catastrophic would easily be the dreaded hip fracture.  More pain, more suffering, loss of function, decreased independence, loss of quality of life.

Patients land in your clinic daily with pain.  A majority of these complaints can be traced back to the bone and joint problems.  In this day and age of pain management sensitivity, your identification, management, and setting of expectations are critical.  This session at the 2019 GAPA will help you successfully navigate this lifelong trek with your patients.


See Dudley Phipps, PA-C, CCD, FLS speak at the GAPA 2019 Summer Conference in Hilton Head Island, SC.

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