Having had chronic knee pain for the past few years, two top New York City orthopedic surgeons recommended knee replacement. Seeking a third opinion, I was seen by Dr. Metzl. After examining me and listening to my concerns he basically said, "Your activity level still is and always has been very high. The thought of you undergoing knee replacement at this time would not be something I would recommend." He suggested a number of more conservative modalities that most likely would keep my activity level up without surgery. I felt comfortable with his approach and appreciated his serious note of how I felt and what I would like to achieve. After about a month of various treatments I undertook one of the most challenging treks in Peru. The Cordillera Blanca. After two days of acclimatizing hikes we proceeded to trek on average eight to nine hours a day for eight straight days. Altitude ranged from 12,000 to 16,000 feet. Many of the climbs were extremely steep with as many as 50 switchbacks to ascend to the summit (or pass) then on average three hours to descend to camp. We hiked to seven different passes (summits) and covered 72 miles in those eight days. Remarkably, I had very little trouble and, ironically, very little hiking experience. Others said I should have surgery and a trek like that would be near impossible for me. Dr. Metzl said, "No. Go for it!" He instilled the confidence I needed and introduced the right therapy to trek the highest tropical hike in the world. He TRULY keeps you in the game. I could not have been more fortunate to cross his path. Future hikes and ski trips are being planned.