Posts by Bryan Barnes2

Angela Wright said:He's facing cancer because of his own risky lifestyle—well... I haven't seen anyone get off-label drugs covered by Medicare without some pushback, since oncologists have to justify it. You know how it goes—those review boards, weighing the hospital budget, being practical (let's be honest, that's just how it works)—deciding if he's actually worth the cost. And then there's hospice, mental health support, second opinions, or the common excuse: "We don't have it right now, but maybe tomorrow once the nurse gets home and brings back the pharmacy keys."
While every addict gets their methadone right on schedule, surrounded by nothing but coddling and sympathy.
Let's just give everyone everything, then, and not act bitter when we're kicked out because they realize the last resuscitation attempt didn't work... honestly, people are unbelievable.🤷

Perhaps I misinterpreted the first sentence... I wrote that he was facing diabetes, not cancer (unless you were referring to fatty liver disease as a potential cause for HCC). 🤔
You didn't answer why one addict is viewed as less valuable than a heavy smoker who develops lung cancer, or someone who spends their whole life eating junk food and bacon only to develop type II diabetes at 150 lbs. Does that mean they don't deserve Metformin simply because their lifestyle directly caused the illness? Or does an addict not deserve treatment because their behavior led to a severe physical and mental dependency—or perhaps just because society views them as social outcasts?

On a side note, since we're discussing methadone, 20 tablets of 5 mg heptanone costs $4.00. It isn't a sum of money large enough to bankrupt the government—nor would it significantly impact the healthcare or federal budget.

As for your point about giving everyone everything... I am referring strictly to the Emergency Room.
We provide care, and we will continue to do so, until primary care becomes more proactive in managing patients (roughly 70% of "emergency" cases could be handled in a family doctor's office).
Until then—which may be never—if you don't call home, you're out of luck.

Quote : Felix the Cat

ambernomad36 said:Gastritis—an inflammation of the stomach lining. It’s much like how rust slowly eats away at an old iron gate if left untreated.
Heart failure—an exhausting reality to face.
Diverticulosis—an issue where small pouches develop in the intestinal wall—is much like a structural weakness in an old highway; over time, the pressure can cause the surface to bulge.
Post-appendectomy status.
Post-cystectomy renal insufficiency (2010) — an observation from my own history.
Nephrolithiasis — left side.
Renal cortical cysts—essentially small, fluid-filled sacs on the outer layer of the kidney—often behave like quiet, uninvited guests in a house; they show up without much fanfare and usually just sit there.
Thyroiditis and Hyperlipoproteinemia — a delicate balance to maintain.
Thyroiditis and Hyperlipoproteinemia—an interesting intersection of metabolic challenges.

I am 55 years old—and I truly feel... 👎

Of course, I still experience bouts of intense pain from time to time—though they don't last long... which is why I’m hoping that, at least in my case, I can hold out for a while.

I am truly grateful for any suggestions, further research, or follow-up checks you might offer—every bit helps.

Perhaps that stone in my left kidney is the underlying cause of these symptoms—it’s hard to say for sure.
Amylase levels might rise—which is a tricky one, since it’s such an unspecific enzyme produced by various organs, including the kidneys.
You should check in with a urologist—there is a chance that a Purchase could be broken up using the ESWL method.

melloworca6 said:Angela Wright—it isn't that they lack the ability, rather it is simply a matter of indifference. They just don't want to deal with the hassle of waiting at a primary care clinic only to end up wandering through various specialist offices like everyone else—instead, they head straight to the ER, where everything is handled at once, and they walk out with their test results in hand immediately.

A biopic—of sorts. 😵
Back when I was still a college student—riding the subway, actually—I overheard an older lady giving some advice to her friend. "Listen, dear," she said, "just head over to Jack—tell them your chest hurts... they’ll take care of everything right then and there. And while you're at it, mention that stinging sensation when you go to the bathroom, so you can get a urine test done at the same time." 🤦

Angela Wright said:There is a triage nurse on duty—if the situation isn't an emergency, they will essentially kick you out of the ER before you even reach the doctor—and one really shouldn't try to play doctor, regardless of the circumstances.

In theory, it sounds wonderful—but in practice, reality tells a different story.

The triage nurse at my facility rarely turns anyone away—in fact, we don't turn anyone away here—because our House rule dictates that every patient must be evaluated by a doctor. Consequently, we end up seeing people who were bitten by a mosquito two days ago; if that swelling hasn't subsided after forty-eight hours of frantic scratching, they are sent straight to the ER.

You should probably try being polite to someone like that—especially after a failed resuscitation attempt on your previous patient... and then you have this one guy with a mosquito complaining about a two-hour wait. To his explanation regarding how you just lost someone you were trying to save? Just give him a cold, blunt response—telling him that his grievance is entirely irrelevant to the situation at hand.

Well... everything just went south—straight to Guatemala.

Angela Wright said:I would personally prefer to see an end to covering addiction treatment through Medicare—it’s a matter of personal responsibility, really. If they chose that path, then they should be the ones to bear the cost of getting clean.

It is the same pattern with alcoholics who end up developing cirrhosis—just as it is with those who develop diabetes by consciously choosing to pack on the pounds. It's much like smokers who face lung cancer despite being fully aware of the risks.
The list continues—much like an endless line at a DMV office.

Addicts are essentially patients—much like the others I’ve mentioned—with one distinction: addicts destroyed themselves through illegal substances, whereas the latter group chose to ruin their health with legal ones. It's a bit of a paradox—their condition is ultimately the result of what amounts to a conscious act of self-destruction.
Whether a substance is considered legal or illegal—that is often just a matter of societal definition—which, in my view, is where the hypocrisy lies regarding who is granted certain rights and who is denied them.

goldenlynx342 said:Thanks for getting back to me so quickly. I'm quite far from Washington, D.C., but as I mentioned—I'm willing to travel anywhere. Could you just clarify how things work over at Manhattan? Do I need a referral, or is it private practice? Should I book an appointment in advance, or can I just show up and wait? Also, do they run the tests as soon as there's suspicion of itching, or do they need to be absolutely "certain" during the exam? Thanks in advance for all the info—and sorry for the barrage of questions, I'm feeling a bit lost here.

P.S. I’d still love for everyone to share their experiences—please send any info related to my first post if you have it. It would be a huge help, not just for me, but for others too.

I believe you'll need a referral from your primary care doctor—though you don't necessarily need an appointment since they have a general dermatology clinic open from 8 AM to 3 PM. Definitely give them a call first, though; it's summer vacation season, so their schedule might be shifted.

Essentially, just mention you've been in contact with someone who has the itching... any dermatologist will likely send you for testing right then and there.

goldenlynx342 said:Hi everyone—I’m looking for some specific advice. Does anyone know a dermatologist anywhere in the US who is actually skilled at identifying scabies when the symptoms aren't super obvious? I need a name and a location—or even just a recommendation for a really thorough dermatologist who won't brush you off after a thirty-second glance. Honestly, I'd travel anywhere in the country for this. My suspicion comes from knowing people I was in contact with about a month ago who definitely had it—even though my own symptoms aren't overwhelming (though I do have a rash and occasional itching). My current dermatologist dismissed it as just a common rash or maybe a sun allergy; the whole "consultation"—which included writing a prescription for an expensive cream—barely lasted five minutes. He looked at my back for maybe thirty seconds tops. It's incredibly frustrating when something potentially contagious is treated so flippantly, especially when there's a valid reason to worry. I don't know who to turn to for a real conversation and a proper exam. Of course, I hope the diagnosis is negative, but I need that to be a conclusion based on actual diligence—I don't want to accidentally spread anything to those around me. If you've dealt with this, please share any advice or names of doctors who might help (ideally private practice, since my doctor won't issue a referral for this). Feel free to DM me. Thanks so much. Best regards.

Manhattan, Dermatology Clinic.
There is a specific skin test used to rule out scabies.

swiftheron7 said:I have three lab results

1. Cervical swab for Enterococcus and E. coli


2. Cervical swab for Mycoplasma hominis


3. Urine culture for Enterococcus


Since I have a sensitivity chart for each bacterium showing which antibiotics they respond to, I'm wondering if Citeral (Ciprofloxacin) is the best choice here—especially since :

a) according to result 1, the Enterococcus isn't sensitive to it

b) regarding result 3, the note mentions Ciprofloxacin is only used for uncomplicated infections.

I am under 30, female, and have a steady partner.
I'm currently on my third antibiotic (first Nolicin, now Cephalexin) and I've been battling infections since winter —so, would it be wiser to choose an antibiotic that covers all three findings?

Also, how is it possible that the exact same bacterium (Enterococcus) reacts to Ciprofloxacin in one test (urine culture) but doesn't react to the same antibiotic in another (cervix)?

Thanks in advance for the help. 🙏

Ciprofloxacin is a solid antibiotic choice. In that first test, the Enterococcus wasn't actually tested against Cipro, so it's safe to assume it's sensitive.

We're likely dealing with a standard, highly sensitive strain of Enterococcus—not some resistant strain like VRE (Vancomycin-resistant Enterococcus), which is basically a living nightmare for hospital doctors.

Both Enterococcus samples are probably the same strain; however, even within the same species, you can have different strains... essentially, one person could carry two different types of Enterococcus, two types of Pseudomonas, or two types of Staph... and so on.
It’s the same bacteria, just varying in their level of sensitivity or resistance to antibiotics.

I don't think we're looking at an allergy here—it would be quite a coincidence for an allergy to manifest precisely where the canker sore is located.
It's more likely just a localized inflammation—perhaps triggered by applying various substances to the area.

Patrick Moore said:Hi there.. I'm 27 years old, and I've been dealing with hypothyroidism for nearly a year now.. I've been trying to conceive for almost twelve months, but nothing has happened yet.. We've gone through all the standard gynecological exams and everything appears normal.., My husband's side is also perfectly fine..
I've had several blood panels done over the past year.. My doctor maintains that everything is within the normal range.. I even saw an infectious disease specialist—he suggested I just keep monitoring my blood work via regular labs.. However, I can see certain deviations—so if you could take a look..
First blood panel, - - - Second blood panel
Leukocytes 8.3(3.4-9.7) - 8.9
Erythrocytes 4.82(3.86-5.08) - 4.32
Hemoglobin 137(119-157) - 129
Hematocrit 0.420(0.356-0.470) - 0.380
MCV 88.1(83.0-97.2) - 88.1
MCH 28.5(27.4-33.9) - 29.8
MCHC 323(320-345) - 339
RDW 12.9(9.0-15.0) - 13
Platelet 232 (!) Leukocyte 6.0 DKS - 241

BNeutrophil granul. 40(44-72)--LOW - 34.6--Low
Lymphocytes 42.7(20-46) - 48--High
Monocytes 5.8(2-12) - 6.5
Eosinophil granul. 7(0-7) - 7
Basophil granul. 0.9(0-1) - 0.7
Neutrophil gran. 3.88 (2.06-6.49) - 3.08
Lymphocytes 3.58 (1.19-3.35)--HIGH - 4.30--High
Monocytes 0.40(0.12-0.84) - 0.57
Eosinophil gran.0.45 (0.00-0.43)-HIGH - 0.43
Basophil gran. 0.06 (0.00-0.06) - 0.06

Three other blood panels were done too.. and they are very similar to these..
All the deviations are the same.. I am just worried about this >.. I feel like something isn't right... Please, any help or advice.. anything at all.. Thanks

There are some isolated deviations here, but I don't believe any of them are causing the fertility issues.
It has only been a year—keep pushing, stay persistent—I truly believe everything will turn out fine and that you will become a wonderful mother one day.
Good luck! 🙂

amberpanther25 said:Two weeks ago, I had two moles removed—they were looking suspicious and changing shape. I'm just trying to understand what they mean by "showing maturation" before my follow-up appointment next week. I'll list the main details from the report here.

Specimen 1: Skin excision measuring 0.6x0.3x0.2 cm containing a dark brown lesion 0.2 cm in diameter
Specimen 2: Skin excision measuring 1.3x0.7x0.5 cm containing a grayish-brown lesion 0.7 cm in diameter

Pathology Report:
1) Histologically, the lesion consists of an acanthotic epidermis with elongated epidermal rete ridges and darkly pigmented basal keratinocytes, along with nests of nevus cells in the basal layers of the epidermis and within the underlying dermis where they show maturation. The described lesion does not reach the resection margins marked by tissue staining.
The same applies to the second mole and the pathology diagnosis listed below.

Pathology Diagnosis: lentiginous composite nevus

They told me the results look fine, but I'm curious about this phrase regarding "maturation." Thanks in advance! 🙂

It means the cells are mature—which, in this context, is a good thing.
It’s the immature cells we actually worry about.

velvetmoose9 said:Mosquitoes? Most biting insects—in general—tend to carry more concentrated venom during heatwaves and dry spells; it’s why you see such intense reactions from most people after a bite.

That's an interesting point. 👍

I had more notes ready, but even I am becoming increasingly forgetful in this sweltering heat—especially given the current pace where 50% of the staff is out, yet we're still expected to hit 100% capacity. 🙂

In my case, 75% of us are out—out of four people, I'm the only one left on the floor—yet the production targets remain unchanged. 😁

OT:
@kemik, you are the perfect patient for the real Dr. House—the one who actually understands medicine, unlike that fraud on TV who just pretends to. 🙂

While this isn't my area of expertise—I'm certainly no doctor—I suspect that simple drafts, or even more frequently, public pools and water parks acting as breeding grounds for bacteria, are the real culprits behind these infections.
It stands to reason, then, that we see a spike in ear infections during those warmer months when everyone is hitting the pool.

Raymond Gonzalez45 said:I felt this little lump about 4-5 cm below my right nipple. It's roughly the size of a grain of rice, and when I press on it with my finger, it feels like it moves around under the skin. Could this actually be breast cancer, and is it even possible for a lump to be located that low down?

Please show this to your primary care physician.

If the change is subcutaneous, it could potentially be a lipoma—which is quite common—but, just to ensure peace of mind, you should visit your doctor.

electricmarlin62 said:Thanks so much
Just one more thing—back when this scan was taken http://s723.photobucket.com/user/luc...t=3&o=1..I actually had a nasty, purulent tooth infection—an abscessed nerve—so I was wondering if there might be some connection there.

Not really. If a bacterial (purulent) infection were showing up in the blood, the lab results would look quite different—but I won't get bogged down in unnecessary technical details.

electricmarlin62 said:Thanks for getting back to me... I was just looking over my old blood work—my Lymphocyte levels have always been elevated (right around when the Hashimoto's started). If you don't mind, could you clarify
Which value represents the absolute Lymphocyte count so I know what to track? Is it the one marked with the percentage, or something else?
Thank you so much.

The absolute count is the number that is NOT expressed as a percentage.
Best regards. 🙂

electricmarlin62 said:Yeah, the leukocyte count is actually 8.9... it was miswritten 😵..
As for the colds—yes, I've had a few standard ones (runny nose and such...)
but nothing with a fever or swollen nodes😉

It’s likely those occasional colds or viruses cause a transient spike in the Lymphocyte count—which, looking at previous labs, seems to settle back to normal eventually (like back in April 2015).

However, once the thyroid condition reaches a more stable phase, if the Absolute Lymphocyte count ever climbs above 4, we might need to consider further hematological testing—but that is a conversation for another day.

For now, while things are just fluctuating slightly up and down, I wouldn't rush into anything.

electricmarlin62 said:Could someone take a look at these three blood panels? I had them done for a check-up..
I have Hashimoto's (hypothyroidism), though I haven't started medication yet..
These results are worrying me—my doctor says they're relatively fine.. But honestly, I'm anxious because everything seems to be slightly high or low.. and this has been going on for quite a long time.
The first two panels are in the links
http://s723.photobucket.com/user/luc...tml?sort=3&o=0
http://s723.photobucket.com/user/luc...tml?sort=3&o=1

And here is the third one
Platelet 232 (!) Leukocyte 6.0 DKS
Erythrocytes 4.31 (3.86-5.08)
Hemoglobin 129 (119-157)
Hematocrit 0.380 (0.356-0.470)
MCV 88.1 (83.0-97.2)
MCH 89.8 (27.4-33.9)
MCHC 339 (320-345)
Platelets 241 (158-424)

Neutrophils 40 (44-72) L
Lymphocytes 48.9 (20-46) H
Monocytes 6.5 (2-12)
Eosinophils 7.1 (0-7) H
Basophils 0.7 (0-1)
Luc 2.3 (0.0-4.0)
Neutrophils 3.08 (2.06-6.49)
Lymphocytes 4.00 (1.19-3.35) H
Monocytes 0.57 (0.12-0.84)
Eosinophils 0.53 (0.00-0.43) H
Basophils 0.06 (0.00-0.06)

This last CBC (the transcribed one) is mathematically impossible—either there was a mistake at the lab or the leukocyte count was recorded incorrectly; please double-check those entered values.

The findings could be—as I have already noted regarding another forum member—consistent with autoimmune issues involving the thyroid. That said, it isn't out of the question that you might have fought off some viral infection earlier this year without even realizing it (do you recall having swollen lymph nodes, a sore throat, or a fever?). However, it is difficult to make a rational judgment about what happened six months ago.
Your doctor is right; the results are more or less okay. Of course, this is within the context of the condition you unfortunately live with—and will continue to carry with you.

Rachel Palmer56 said:... undergoing evaluation by a rheumatologist with an undefined diagnosis still pending.
Actually, for the last year, my leukocyte count and ESR have been consistently elevated—just a few months ago, my leukocytes were at 21.
ESR (erythrocyte sedimentation rate) 1 hour 38

Because of that, these results actually bring me some relief.
Leukocytes, as I mentioned, are 8.91

ESR 18

Erythrocytes 3.93

Hemoglobin 138

Hematocrit 0.333

MCV 85.2

MCH 35.2

MCHC 413

RDW 12.7

Platelet 232 (!) Leukocyte 6.0 DKS

MPV 5.9

So, that is the full picture from two weeks ago. In the meantime, my lymph nodes have swollen up—I'm hoping everything is fairly okay. Thanks in advance for any insight. 🙂

Oh, and I am also waiting on these results, which should be ready in about two weeks: CRP, RF, ANA, ENA, C3, C4, CIC, IgG, CIC, IgM, CIC, IgA, ELP.

The silver lining here is that you aren't anemic. Generally speaking, the blood work looks fine—nothing that would necessitate rushing into emergency testing right this second.
Given the relatively high MCHC, I’d suggest rechecking your CBC in about a month. If the MCHC remains at those levels, it might be worth doing some follow-up tests—primarily to rule out cold agglutinin disease. Have you ever dealt with low hemoglobin or elevated bilirubin levels before?

I see you're waiting on immunology panels before seeing the specialist; rheumatologists are usually excellent diagnosticians, so you are likely in very good hands.

Good luck.

Melissa Thompson86 said:Here is the complete report:
Erythrocytes 4.09 (3.86 - 5.08)
Hemoglobin 124 (119 - 157)
Hematocrit 0.370 (0.356 - 0.470)
MCV 90.5 (83.0 - 97.2)
MCH 30.3 (27.4 - 33.9)
MCHC 335 (320 - 345)
RDW 12.2 (9.0 - 15)
Platelet 207 (158 - 424)
MPV 7.6 (6.8 - 10.4)
Leukocytes 4.2 (3.4 - 9.7)

DKS
Eosinophil gran. 2.7 (0 - 7)
Basophil gran. 0.6 (0 - 1)
Neutrophil gran. 42.1 (44 - 72)
Lymphocytes 48.5 (20 - 46)
Monocytes 6 (2 - 12)

Metabolites and substrates
Glucose 4.7 (4.2 - 6)
Total Bilirubin 8 (3 - 20)
Urea 3.5 (2.8 - 8.3)
Creatinine 66 (49 - 90)
Urate 204 (134 - 337)

Enzymes
AST 17 (8 - 30)
ALT 12 (10 - 36)
GGT 12 (9 - 35)
(S) AMS 87 (23 - 91)
(U) AMS 227 (< 400)
ALP 34 (54 - 119)

Electrolytes
Potassium 4.3 (3.9 - 5.1)
Sodium 137 (137 - 146)

Trace elements
Iron 15 (8 - 30)
TIBC 63 (49 - 75)
UIBC 48 (26 - 59)

Lipids
Cholesterol 5.1 (< 5)
HDL 1.6 (> 1.2)
LDL 3.1 (< 3)
Triglycerides 0.9 (< 1.7)
Serum appearance - clear

TSH 9.62 (0.4 - 4)

Age 28, 5'5", 115 lbs

The leukocyte count is normal, absolute neutrophil numbers are within range, and there is no absolute lymphocytosis. All good news!

I should also mention—to clarify—that another name for Hashimoto is chronic lymphocytic thyroiditis; essentially, the primary cells attacking the thyroid are your own lymphocytes, unfortunately.
Because of that, I would absolutely agree with your family doctor and align myself with the view that these results stem from Hashimoto.
The blood work is almost a textbook case. 😉

Rachel Palmer56 said:Hi 🙂

I was wondering if someone could help me make sense of these results—my doctor is currently on vacation, and I really don't want to bother a different one...

Hematocrit: 0.333 (3.86 to 5.08)

MCH: 35.2 (27.4 to 33.9)

MCHC: 413 (320 to 345)

MPV: 5.9 (6.8 to 10.4)

Erythrocyte sedimentation rate is 18 and leukocytes are 8.91—so those seem fine for now.
Thanks in advance 🙂

Please include the parameters that are within the normal range too. Without the full panel, trying to interpret anything is difficult—and frankly, a bit irresponsible.
It might also be helpful to mention why you had the blood work done in the first place; having some context makes everything much easier to evaluate.

fadedsailor17 said:My serum results show Mumps IgG 24—with the reference range being positive if it's over 11 and negative if it's under 9.
As for the VZV IgG—it came back at >2000—whereas the standard reference range is anything above 50 to be positive, and below 50 to be negative.
And yes—right next to those, it actually says "POSITIVE."

The CSF analysis shows VZV IgG at 110—given that the reference range is positive above 100 and negative below 50—so it's marked here as "REACTIVE."

Does anyone know what these numbers are supposed to signify?

Is the IgM negative? If only the IgG is positive, it simply means you have immunity—likely from having chickenpox as a child, much like most Americans—as well as immunity to mumps, probably due to vaccination. It’s certainly nothing to worry about.

Quote : Felix the Cat

Anthony Ortiz3 said:Greetings!

My two-year-old son underwent a KKS due to a fever of 101.6°F—everything came back within the normal range, with the exception of his MCHC, which was 371 (ref: 300-350).
At 15 months old, his Hgb was low (84) along with his red blood cell count—which led me to provide 5 mg of divalent iron daily, plus Vitamin B12, for four months—after which his CBC returned to normal levels (today's values: RBC 4.15; Hgb 120).
Is there any basis to suspect spherocytosis?
Thank you in advance for your response.

If all the other values fall within the normal range, I wouldn't panic—nor would I jump to conclusions regarding spherocytosis quite so quickly. It might be best to have the child's CBC rechecked in a month; if the MCHC remains elevated at that point, then you should consult their pediatrician to discuss potential follow-up testing. For now, I wouldn't rush into anything.

Quote : Felix the Cat

Melissa Thompson86 said:Greetings,
A year ago, I was diagnosed with Hashimoto and vitiligo. Since then—having checked my blood work several times over this past year—every single lab result shows low neutrophil granulocyte levels paired with elevated lymphocyte counts.
Latest finding: granular neutrophils. 42,1 (44 - 72); Lymphocyte 48,5 (20 - 46).
The issue is this—my primary care physician insists everything is fine, claiming it’s just an inflammatory process in the thyroid that will settle down once things stabilize. On the other hand—and this is where it gets complicated—both my endocrinologist and dermatologist are telling me it isn't a thyroid issue at all; they believe there is an underlying problem elsewhere and suggest I see a hematologist instead.
So now I find myself wondering—is there actually any reason to be concerned here, or is this specific blood work truly just characteristic of Hashimoto?

It feels somewhat ungrateful to comment without having the absolute numbers—specifically the leukocyte count. After all, there is a significant difference between a total leukocyte count of 10 and one of 5. Please rewrite the entire KKS report.

rustyowl4 As stated by:
I have attached those recent photos—just so you can try to get an approximate sense of the current condition.

1
2

The imaging shows some subchondral sclerosis medially—specifically along the lower tibia—as well as some patellofemoral osteoarthritis. It’s important to note that these changes are just early signs; we aren't looking at an advanced stage yet.
Without knowing if these levels were the same six months ago—it’s a bit like trying to judge a stock trend without seeing last quarter's closing price—it is difficult to determine if this result is an improvement or a decline. You will really need to discuss this with your doctor during your follow-up—since they are the ones who have your previous medical history on hand.

X-rays don't show the meniscus or ligaments—something you likely already know—but they simply aren't designed for that kind of detail.

Ultimately, what matters most is how you’re feeling after physical therapy—specifically whether that knee feels more mobile or if there's still pain during movement. An X-ray is really just a tool for monitoring—a way to ensure we aren't seeing any further progression of changes that have already occurred (which, much like a dent in a car bumper, likely won't just disappear—once cartilage is damaged, it's incredibly difficult to restore).