Know Your Bones

Anatomy Exhibit at RMSC 9/1-1/1: GO!

Anyone with a body must see Our Body: The Universe Within at the Rochester Museum and Science Center.

See my interview on Channel 10:  Watch the Video.

It's a rare opportunity for you to appreciate how architecturally marvelous your body is.  The coolest part of these specimens is that they're in action poses.  You've only seen drawings of bodies in the static "anatomic position" before.  Now you'll get a better idea what stuff does, not just where it is, and really Know Your Bones!

Once you see how the knee bone's connected to the hip bone, you'll understand how to manage your joint pain. 

The specimens are incredible--respectfully, scientfically, artistically displayed.  These are/?were? real dead people!  There's no odor, but unfortunately you can't touch the "plastinates", as they're called.  Even my doctor colleagues haven't this chance since freshman anatomy lab in medical school. 

The artistry of these specimens isn't as good as the Bodyworlds exhibit, but it's certainly worth the $20 ticket--the price of a co-pay!  Go!

Sitting is Hazardous to your health!

Go out and buy the Holiday issue of Woman's Day magazine!  On page 54, you'll find a helpful article featuring moi, and several other orthopedic surgeon/authors like Dr. Nick.  Like I said, the #1 reason patients come into my office is because they sit too much, and with poor posture!

Some pearls:   

• Don't slouch, it puts pressure on your spinal discs and causes soreness in the lower back.
• Make small, simple changes to your routine to ease sitting-related aches and pains.
• Take breaks to stand, stretch and walk every half-hour.   Stretch while on-hold.
• Exercise daily--it lubricates your joints and enhances the elasticity in your tendons and ligaments.
• QUIT SMOKING!  Smokers ALWAYS have more pain than non-smokers because their muscles are starved for oxygen and blood-flow!
• Position your chair and computer/work station so you don't have to reach or strain constantly.  Use a headset for the phone.
• Take breaks from constant typing to stretch your fingers, wrists and elbows to prevent tendonitis and carpal tunnel syndrome.   Set a timer at your desk every 20-30 minutes.
• Have your vision checked--one patient came to me, the bone doc, because his neck and shoulders hurt so much from tipping his head back to read--he needed new glasses!

Thanks to Arricca SanSone for the interview, and to Woman's Day for this important Public Health Announcement!

Patients as customers?

Here we go again--is it the chicken or the egg?  Or, is it the cart before the horse?  Or, will doctors' offices get their acts together and learn to treat patients like hotel guests before those patients drop their HMO's for HSA's?  Elisa's got some valid points at Healthy Concerns--but we all need to take a deep breath. 

For over 20 years now, HMO's have led everyone to believe that everything's covered all the time, and it'll only cost you $5 co-pay.  Well, those days are over.  Now that you're paying $8k/year to insure your family, you're probably going to believe the promises of "consumer-driven health plans" to save you $$ and "right-size" your health budget.

Not so fast.  You know the arguments against price-fixing that apply to the rest of the business world (like, don't cap the price of oil, because we did that in the 70's and the oil companies didn't expand and innovate, and now look where we are)?  Well, your doctors been operating under fixed prices for decades--Medicare, HMO's, PPO's, etc...have told us what we'll be paid regardless of the level of service we provide.  Guess what happened.

Under the payors' fixed-prices, your doctors don't have the capital, the drive, the intellectual resources, the managerial expertise, whatever else it takes to zoom into customer-service overdrive and satisfy your every whim. 

Now, I'm a fan of consumer-driven health plans, personal responsibility and HSA's.  But be patient while your doctor re-tools his production line to respond to these new market forces. 

Kevin, MD found a pie-chart that says policyholders would rather trust their insurance companies than their common sense--check it out, as well as the commentary.

Where should we start?

Problem with dissolvable stitches; how about a dissolvable HMO?

See an unfortunate mother's anxiety about her baby's dissolvable stitches at the Knee Board.

Why wouldn't/couldn't she just get an answer from the baby's surgeon?  Are patients so brainwashed by their HMO's that they believe every move requires a referral from some gatekeeper? 

Surgery for Pat's Shoulder tendonitis?

Although muscle and joint pain accounts for 20-25% of all primary care doctor visits, chances are, your doc has had no formal education in the musculoskeletal system. 

Visit my post at ThirdAge--what do you think of Pat's approach?  Have you had a similar experience? 

Perhaps the root of the problem can be found in our fractured health system:  Patients go from zero to 60 when their primary care physicians send them to an orthopedic surgeon.  We are surgeons, operating is how we solve problems. The fact is, there are few stops along the way to ensure patients get top-notch non-operative treatment.  Know your bones--nobody else does!

Debbie's ankle replacement

Debbie posted a question at Third Age, asking if ankle replacement was a good idea.      She had a bad fracture, and will see a specialist for a second opinion next week. 

There's a lot at stake--not just if one fairly new, very specialized, technically-demanding, controversial procedure is the answer! 

See my answer at Third Age:  get advice for an effective second-opinion specialist appointment. 

Get up, get out, get moving---and save your bones!

The National Osteoporosis Foundation encourages you to realize the importance of exercise in building healthy bones!

Today, October 20th is "Virtual Fitness Day" to encourage all individuals to take personal responsibility and individual action to "Stand Tall Against Osteoporosis" and to build strong bones for life!

Participation is easy: simply perform your normal daily fitness routine on October 20th. If you don't have a normal fitness routine it's time to get started and prevent osteoporosis as well as improve your overall health! Take the steps, park your car in the back corner of the lot or "walk the block" with friends! Visit NOF's website at http://www.nof.org/ and make an online pledge today.

Get your patients, co-workers, friends and family members to join you! Working together, we can improve the quality of life for people living with or at risk for osteoporosis. We are grateful for your commitment!

Listen to your body!

Read Pat Sample's advice on listening to your body's signals, and feel better immediately!  She's done a great service by suggesting that people look inside for what triggers their symptoms.

Most of my patients’ problems come from taking their bodies for granted: expecting aging knees to perform flawlessly while carting around an extra 50#, surprised their necks and shoulders hurt after hunching over a desk all day, etc…Add emotional/spiritural strain to mechanical malalignment, and these folks are hurting!

Understand that pain is how your body asks for something:  Good posture, flexible/resilient muscles, a reasonable workload go a long way toward preserving a painless persona. Sure, if you need to have something fixed with an operation I’m happy to do it. But, most people don’t need that. Don’t equate “there’s nothing I can do” with “there’s nothing that can be done.”

Donate a mammogram!

It only takes a minute....
* Y * 6 * Y
Please tell ten friends to tell ten today! The Breast Cancer site is having trouble getting enough people to click on their site daily to meet their quota of donating at least one free mammogram a day to an underprivileged woman. It takes less than a minute to go to their site and click on "donating a mammogram" for free (pink window in the middle).

This doesn't cost you a thing. Their corporate sponsors/advertisers use the number of daily visits to donate mammograms in exchange for advertising.

Here's the web site! Pass it along to people you know.

http://www.thebreastcancersite.com

Exploring Fibromyalgia's Mysteries

  My friend, Marianne, sent me an LA Times article that seems to be the cutting edge of treatment, and opinions, on fibromyalgia.  I think the near future holds a lot of useful information—understanding of brain physiology is a lot better than even 15 years ago, when I was in med school.  Time will tell if any of the drugs they mentioned will pan out—limited by cost, accessibility, drug interaction and side-effects? 

Mare and I have a mutual friend, Jean, dealing with fibro—have you tried any of these meds?  What works best for you?

New discoveries to explain this stuff from a biochemical/physiological standpoint will go a long way toward convincing my colleagues that it’s real.

I’m becoming a fan of meticulous nutrition, sleep and activity modification for patients with any kind of health issue:  joint pain, high blood pressure, diabetes… The body wants to be balanced/well; if it’s got plenty of reserves, it can withstand poor habits, and you’re “lucky” and “healthy”.  But when its reserves are overwhelmed (and I’m guessing that some people have fewer reserves than others), then you get symptoms and disease.  Meticulous attention to good habits boosts the body’s reserves, minimize symptoms, and get closer to balance/wellness, reducing the need for drugs. 

I think I might order that infomercial-guy’s book on Natural Cures from late night TV!  He makes a lot of logical points!