This is so difficult

[Anjuli_Bai]

My daughter had a very similar problem with her ankle. We also saw Dr Wolman who advised the cortisone jabs plus physiotherapy. Unfortunately this was insufficient to help her get over her situation and eventually surgery was necessary. This was done by an associate of Dr Wolman, Mr Nick Cullen. Both Dr's were marvellous and it so helped that they fully understood the demands placed on the joints of someone wishing to be a professional dancer, not always the case with some of the doctors we saw initially. Its been a bit of journey from prognosis in my daughters 1st year of 16+ vocational school to where we are now but she has come through this a much more resilient person emotionally. I wish you the very best with whatever route you go down.

 

 

Please excuse this completely off topic question....but....

 

Why in the UK is one doctor (Wolman)called given the title "Dr." while the other doctor given the title "Mr." (Nick Cullen) and then later referred to as a Dr. ("both Dr's".) - ?  Is there a difference in education/expertise level and if so why is Cullen later referred to as a "Dr."?

 

 

Thanks for your patience.  (no pun intended - well, okay, just a little bit intended)

[straighttothepointe]

Its very archaic as are a lot of things this side of the pond. Back in the day there were the medically trained people, the Doctors and then there were the non medically trained surgeons, who, were generally and literally butchers (and barbers) so just had the title Mr. For some reason it still stands today although thankfully today surgeons are a little more adept at their craft than they were a few hundred years ago. Sorry I resorted to a generalisation of the fact that they both are in fact doctors!!

Edited September 24, 2014 by straighttothepointe

[Anjuli_Bai]

So - surgeons are "Mr."?   How about if the surgeon is a woman - would she be a Ms? Miss? Mrs?

 

Thank you for helping me to understand this.

 

(a non-medically trained surgeon is a scary thought!)  But at one time they were often the local barber!

[straighttothepointe]

So if its a female its Mrs, Miss or Ms. Yes they were often barbers hence the candy striped barbers pole outside their place of work to signify blood and bandages

[Pups_mum]

The history and modern day usage of this terminology is quite interesting. It does indeed hark back to the days of the old Barber Surgeons, when the Physicians' colleges would not allow surgeons the title doctor, as they felt they were beneath the more educated physicians, and not worthy of the title. So "Mr" was a kind of insult really.

Time went on, and surgeons became possibly the more influential group with, in many circles, the higher status and income. So instead of "Mr" being a sign of inferiority, it became something of a status symbol, differentiating surgeons from all other kinds of doctor. So now you have the situation where a medical student will be Mr, until he qualifies and is proud to be Dr for a few years at least. Then once he passes his final surgical exams and becomes a Fellow of the Royal College of Surgeons he reverts back to being Mr! Female surgeons can be Miss, Mrs or Ms according to their own wishes, but as it is common for female doctors of all specialities to continue to practice under their maiden names, Miss is commonly used, even by married women. So you could have a female surgeon who is called Miss Smith, even though she is in fact married to Mr Jones.

And to cap it all, "Doctor" is a courtesy title for all but the relatively small number of medically qualified doctors who hold a doctorate qualification (PhD or MD) anyway. Most UK doctors' primary qualification is Bachelor of Medicine & Bachelor of Surgery and then they sit postgraduate diplomas in their chosen speciality. MD is essentially a research qualification and means something different here than in the USA.

I bet you wish you'd never asked now Anjuli!

[Anjuli_Bai]

I'm glad I asked.  

 

Here anyone who has earned  a Ph.D or an MD is called "Dr."  including those who receive an "honorary" doctorate degree.  I think Margot Fonteyn received one - but I never heard her referred to as Dr. Fonteyn!  

[Pups_mum]

Oh yes, the same here. All PhDs and MDs are called Dr. The difference is that most medical doctors in the UK don't have an MD - the system is quite different to the US.

[DancingPixie]

If you have a PhD or equivalent you would use the title Dr probably only if you worked in education or academia.

[Klaris]

If you have a PhD or equivalent you would use the title Dr probably only if you worked in education or academia.

This made me chuckle, as my Mum (who earned her PhD relatively late in life) has stopped using Mrs for everything and now only ever refers to herself as Dr - she uses it at any and every opportunity, which we all find really embarrassing. My son had to have a major operation a couple of years ago and she happened to be visiting when the consultant was doing his rounds - he genuinely thought Grandma was a fellow medic, which brightened her day considerably. Still, we learnt quite a lot more about the technical side of the operation than we might otherwise have done...

[Moomin]

Everyone I know who has a doctorate uses 'dr', fair enough I say, they've earned it! Never met a female surgeon using mrs or ms, only Miss

[Cara in NZ]

We have a friend who is an obstetric consultant and uses Mrs.

[CeliB]

out of interest I once had a quite snippy person argue with my usage of my title Dr (academic) as he believed it was misleading and should only be applied to medics. So I looked up the origins of the title and in fact the usage of Dr for people with higher academic study predates the use of Dr for medically qualified people by some 500 years!! So it's the academics who are 'real' drs if it comes to an argument!!

I too have come across female surgeons who call themselves Mrs..

[Stitch]

Spacy,

I've been thinking about your case ever since your first post.  You mentioned in your third post of September 18th that you, "… think the bone is sharp".
If somewhere along your decision process you can get hold of the MRI images and study them, then you might be able to see for yourself if, indeed, the bone is sharp.  I would think that even a layman should be able to see such a thing.  If a sharp bone is the diagnosis, but they can't show it to you, then I would be hesitant about surgery.

But there is something else.  In that same post you mentioned that, "DD also had a huge growth spurt in the past year …".  I'm wondering if that might have something to do with her inflammation.  Maybe the rest of her body just needs a little more time to catch up.

[ParentTaxi]

I have a PhD, but use Dr only for dealing with official bodies, and when getting telephone salespeople off the phone (Is Mrs ParentTaxi there? No, sorry, she died 10 years ago..[my MIL was the last person who was just 'Mrs ParentTaxi', and she did indeed pass away 10 years ago]).

 

In my 'day job', I use Mrs as it just seems less pretentious, because I no longer work in the field of my PhD. In all other parts of my life, i am of course simply 'DD's mum' or 'DS's mum'!!

[Spacy]

Hello stitch,

 

thank you for your reply.

I think you are right that DDs huge growth spurt may have been part of the problem. We have been seeing a dance physio who recommends that we wait for a while before surgery. She has given DD some specific strengthening exercises and DD feels that her calf muscles are feeling much stronger. DD is back dancing pointe and jumping, and is very happy! Ankle feels better-DD says it is just like a dull ache now. I guess not using it fully for 6 months would result in it becoming very week so difficult to make a good assessment of injury.

we have another appointment with Dr Wolman in December although he did say to let him know decision before then. DD wants to continue with exercises and to audition next year so fingers crossed. Even if DD has to have surgery eventually it seems to me better to wait until she gives her body time to adjust to her growth spurt.

I have to say I really thought this wouldn't get better by itself but I hope I am wrong!

I have learned it is important not to do things too quickly and I would always see a specialist dance physio even if we have to travel a long way.

[CeliB]

The issue of growth spurts is quite interesting to me as DS has been carrying a hip injury for a little over a year which many of his teachers attributed to 'just a growth spurt' and kept reassuring us that it would get better as he adjusted to his new height. I was less convinced at it seemed to me quite a specific injury and only on one side- presumably he didn't grow 6 inches on his right but not on his left, so why would a growth spurt cause be one sided (i can see how it might affect flexibility, back problems, balance etc or even say both ankles, but not just one).

 

He then had various clinical people look at it and say the hip pain was due to muscle strain in his upper back, shoulder and neck, which certainly makes sense, but then no-one seemed to be able to suggest the cause of that muscular problem.

 

Soooo, he then got a new teacher this year who within one week noticed that he stands at the barre very slightly twisted one one side, and also is leaning back (almost microscopically) when doing leg lifting (grand battement type stuff I guess). He has taught DS to check his sideways alignment more carefully and not to lean at all. BINGO!!! no more hip pain.

 

So I suppose the moral of the story is- has anyone actually looked at the way your DD practises in a more analytical manner to see if there is anything she is doing which might be contributory? I was amazed how such an tiny error for DS was having such a massive impact....

[drdance]

CeliB I'm really pleased your DS's issue has been identified - that was my dream job for many years; identifying the technical causes of problems and correcting them, and working closely with the dancers to rehab injuries with a view to being preventative. Sadly no such job exists yet!

[CharlieChuck]

Get in contact with Lisa Howell, she is simply amazing and her advice to me whenever I got back into Ballet after being incredibly ill for a good few years was amazing. I strongly suggest getting as many opinions as possible before settling on a solution. Have you talked your DD's main instructor, if she has more than one maybe try and sit down and have a talk with all of them. Get them to explain to your DD what is at risk if she were to not recover properly as by the sounds of it she is very passionate and I would hate for her to rush into things. But as stated previously 17 is certainly not to young. I strongly suggest she focuses more on her school work than her dancing and then once that is out of the way then she give her dancing a 110%. What I did whenever I fell ill is I focused my attention in getting better but did gentle exercises and techniques to keep me supple but nothing to much that would knock my health/.recovery down again. I think her main concern right now is to make sure she doesn't injure herself further as although there maybe a solution at the minute if she pushes herself too much she may not be able to fix it. 

 

Good luck

[Karen]

CeliB I'm really pleased your DS's issue has been identified - that was my dream job for many years; identifying the technical causes of problems and correcting them, and working closely with the dancers to rehab injuries with a view to being preventative. Sadly no such job exists yet!

Dr Dance, when my dd had a foot problem 3 years ago, the sports physio we were seeing could not identify the cause of the problem. She sent dd to some sports therapy research friends at a local university and they attached a set of sticky pads to her foot and then put her through her movement paces. The film of the movement was then analysed and they concluded that dd's movement was normal and balanced and she was not contributing to the injury through her every day dance action. If it had been, they would have advised a more appropriate way of using he foot through various movements and strengthening/ stretching exercises as appropriate. It was a very interesting a helpful afternoon (and dd loved running down the track and jumping into the foam filled pool at the end as well!)

[straighttothepointe]

FWIW...my daughter had several types of imaging on her ankle, ultra sound MRI and X-Ray but unfortunately it was not until the surgeon 'went in' that the bone spur was discovered. It was tiny but was enough to cause a myriad of problems for a ballet dancer in training. Had we known that from the beginning the route we took to resolution may have been different. I do agree however surgery has to be the last resort option.