Dangers and Risks of Putting Off Knee Replacement Surgery

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Patients often delay knee replacement surgery because of fear of the procedure or concerns about the recovery process. Interestingly, while many people worry about what could possibly happen if they undergo knee replacement surgery, fewer stop to think about what will likely happen if they wait:

  • Increased knee pain
  • Further damage to the joint
  • Reduced mobility and ability to use the knee

Continuing to delay knee replacement surgery can bring about serious consequences, such as the inability to walk, work and perform normal daily tasks.

Knee Replacement Surgery May Be More Complex the Longer You Wait

The longer a patient waits to have knee surgery, the more complicated the surgery can become. Here are some ways the procedure can become more complex when a person delays knee replacement surgery:

  • The knee may become deformed and therefore harder to replace
  • The surgical procedure can take longer
  • Kneecap resurfacing may be required
  • Options may become more limited. For instance, early on, a patient may only need a “partial” knee replacement, but if they wait, they may need “total” knee replacement — which is a more complex procedure.

Delaying Knee Replacement Surgery May Diminish Health

Patients who are relatively healthy when they have a knee replaced are more likely to recover sooner. The longer patients wait and allow their knee issues to affect them, the more it impacts overall health. For instance, an inability to walk without pain may lead to avoidance of exercise and weight gain which will put even more pressure on the painful knee.

Make a Knee Replacement Surgery Appointment

So, what’s the smart choice? If you are experiencing knee pain, make an appointment with your doctor and find out if knee replacement surgery or another type of treatment is right for you. Knee replacement may not be the only option, and there may be a different therapy such as a cortisone injection or medication that can help.

Most patients who have had knee replacement surgery not only report positive outcomes including reduced pain or complete freedom from knee pain, many say they would have had knee replacement surgery sooner.

Why is a Colonoscopy Important?

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A colonoscopy offers the best protection against colon cancer, the third-leading cause of cancer death. Studies suggest that colonoscopies reduce deaths from colorectal cancer by 60 to 70 percent (source: National Cancer Institute).

Colonoscopy is the Most Comprehensive Colon Cancer Screening

Colon cancer begins as an adenoma (abnormal growth) in the colon or rectum called a polyp. During a colonoscopy, a doctor can detect and remove polyps before they develop into cancer.

Other colon cancer screenings like fecal occult blood tests or stool DNA tests can detect the presence of blood or DNA biomarkers in the stool, but they cannot be used to confirm a diagnosis of colon cancer. A colonoscopy is the only screening that includes a visual exam of the entire colon and rectum. Using a colonoscope, a gastroenterologist can view the colon on a screen and remove any developing polyps.

The rate for detecting these polyps is the adenoma detection rate (ADR), and you should be looking for a physician with an ADR of at least 15 percent in women and 25 percent in men.

Colonoscopies Detect Cancer Earlier than any Other Test

Colonoscopies are essential because colon cancer is highly treatable when it is found early. In fact, colon cancer is over 90 percent treatable in the early stages. When colon cancer reaches an advanced stage, it is no longer contained in the colon and has metastasized to other organs.

People rarely experience symptoms in early stage colon cancer, so you cannot rely on physical sensations. At diagnosis, many patients claim to feel fine and say that there was nothing to alert them that they had colon cancer. Warning signs like abdominal pain, bloody stool, rectal bleeding and weight loss are often indicators of advanced stage colon cancer, which is challenging to treat.

Call a Gastroenterologist

If you are 50 or older, talk to your doctor about getting a colonoscopy. If you are African American, you should get screened beginning at age 45. Other risk factors, like family history, could also lower your screening age, so make an appointment so you can get screened appropriately.   

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Save Your Vision – Schedule an Eye Exam

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Detect Cataracts, Glaucoma and AMD Early

The goal of Save Your Vision Month is to increase awareness about the importance of quality eye care. The American Optometric Association recommends Americans of all ages visit an eye doctor for a yearly eye exam.

A comprehensive eye exam with dilation promotes early detection of conditions like cataracts, glaucoma, diabetic retinopathy and age related macular degeneration. When eye disease is diagnosed in the early stages, it is much easier to treat, and the outcome is more favorable. Conditions like glaucoma and macular degeneration often do not have symptoms early on, so prompt intervention is necessary to prevent vision loss.

Workplace Eye Health and Safety Month

Every year, over 20,000 eye injuries occur in the workplace. Workplace Eye Health and Safety Month reminds us to be intentional and mindful of eye-healthy practices. If your eyes may be exposed to chemicals or flying debris, protect your vision with appropriate eyewear like safety glasses, safety goggles or face masks.

You might think that eye injuries only happen on construction sites and on factory floors, but eye damage can occur in any setting. One of the greatest hazards to eye safety is digital eye strain. Staring at digital screens for multiple hours per day can cause eye fatigue, blurred vision, neck and back pain and dry eye. If not treated properly, digital eye strain can threaten productivity in the workplace.

A simple, effective way to relieve the symptoms of digital eye strain is to follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. This will allow your eyes to relax as you find a new focal point (source: Rebuild Your Vision).

Schedule an Eye Exam to Help Insure Vision Health

March is the ideal time to make an eye exam appointment and renew your commitment to healthy vision. Your ophthalmologist will test you for refractive errors, focusing problems and eye conditions, and you can discuss the results of your comprehensive eye exam that day. You can leave your appointment knowing you have the most updated prescription for your vision needs.

If you have concerns about digital eye strain or eye safety in the workplace, discuss these issues with your ophthalmologist. Quality eye care is just a phone call away.

Colon Cancer Awareness Month 2018: Everything You Need to Know

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Because colorectal cancer prevention is so important, in 2000, advocates for colorectal cancer awareness joined together and designated March as National Colorectal Cancer Awareness Month. The goal was to raise awareness about the disease, to motivate people to talk about colorectal cancer prevention and to encourage screening.

This is a particularly important year for National Colorectal Cancer Awareness Month: that is because it is the culmination of the “80% by 2018” initiative. Through “80% by 2018,” hundreds of organizations across the nation joined together and pledged to do their part to help eliminate colorectal cancer as a major public health issue. Their shared goal is to impact 80 percent of the eligible U.S. population so they get screened for colorectal cancer by 2018.

Pledge to Talk About Colorectal Cancer

This year, why not support the “80% by 2018” initiative on your own? Talk about colorectal cancer prevention with your family, friends and co-workers. Here are some facts you can share as part of your discussion:

  • Colorectal cancer is the nation’s second leading cause of cancer death for both men and women
  • It is highly preventable if you get screened regularly beginning at age 50
  • Over 90 percent of those who develop colorectal cancer are over age 50
  • You could have colorectal cancer and not know it, therefore, screening by a doctor is important
  • Colon cancer symptoms include blood in the stool, cramping or stomach aches that persist, and unexplained weight loss

Some People Are at Higher Risk

You should also be aware that certain people are at higher risk for the disease and make a special effort to talk to these individuals about colorectal cancer prevention. Risk factors include:

  • Having a family history of colorectal cancer or polyps
  • Having Crohn’s disease or inflammatory bowel disease
  • Not getting enough exercise
  • Not eating a healthy diet
  • Using alcohol or tobacco
  • Being overweight or obese

About Preventive Screening with Colonoscopy

According to current colon cancer screening guidelines, men and women of normal risk should have a colonoscopy at age 50 and every 10 years thereafter. During the colonoscopy, a physician will view the length of the colon and rectum through a colonoscope to look for any abnormal growths.

The doctor can usually remove any polyps found during the colonoscopy, so the patient does not need to undergo another procedure. Although most growths found in the colon are benign polyps, some can become cancerous, so the removed tissue is sent to a lab for testing.

Learn More

To learn more about National Colorectal Cancer Awareness Month, visit www.ccalliance.org/awareness-month.

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You’re Never Too Young for Colon Cancer

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Why Young-Onset Colon Cancer is on the Rise

Although colon cancer incidence among Americans over the age of 50 is declining, young-onset colon cancer is on the rise. This may be for a few reasons:

  • Publications and educational materials about colon cancer screening and prevention tend to be targeted to people who are 50 years of age or older.
  • Younger people are unfamiliar with risk factors and warning signs for colon cancer.
  • Younger people are often unaware of their family health history.

Importance of Increasing Awareness of Young-Onset Colon Cancer

Disease prevention begins with knowing the symptoms. However, colon cancer can be a challenging disease to diagnose because there are often no warning signs in the early stages. For those who do experience symptoms, the indicators may include:

  • Abdominal pain
  • Blood in stool
  • Change in bowel habits
  • Unexplained weight loss
  • Bloating, fullness or cramps
  • Vomiting

Being familiar with common symptoms of colon cancer helped Missy, age 26, know that she needed a colon screening. She wrote the following in a testimonial: “Thanks to nursing school, I was able to recognize the symptoms. I insisted my GI doctor perform a colonoscopy. I believe it was the early detection and treatment that stopped the stage 1 from becoming a much bigger problem. Don’t be afraid to get screened!” (source: Colorectal Cancer Alliance).

Listen to Your Gut and Speak up About Colon Cancer

Since colon cancer is on the rise among younger people, it is important to pay attention to your body. If you experience any warning signs of colon cancer that persist or worsen, make an appointment with a gastroenterologist.

The good news is that colon cancer is over 90 percent treatable when it is discovered in the early stages. Don’t be afraid to speak up and ask to be screened. It is important to know if you have a family history of colon cancer because that could make you eligible for early or more frequent screenings. If you have any concerns about your colon health, make an appointment with your GI doctor today.

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Common Eye Infections and When to go to the Doctor

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Pink Eye

Pink eye is the common name for conjunctivitis. It can be bacterial or viral, but the warning signs are similar: eye redness, swelling, burning and discharge. Viral conjunctivitis usually causes a watery discharge with crusting in the mornings, while bacterial conjunctivitis typically results in a constant, thick, yellow or green discharge. Pink eye is highly contagious and spreads quickly, especially in schools and day care centers. An ophthalmologist will usually prescribe antibiotic eye drops for bacterial pink eye.

Bacterial Keratitis

Bacterial keratitis is an infection of the cornea, the clear dome in the front of the eye. It is caused by pseudomonas bacteria found in soil and water or staphylococcus bacteria carried on human skin. Contact lens wearers can develop bacterial keratitis, but people who do not wear contacts can develop it as well. Although bacterial keratitis is not contagious, it can develop quickly and can cause vision loss if left untreated.

Stye

A stye develops when an oil gland in the eyelid or eyelash becomes infected with bacteria, usually bacteria that is normally found on the skin. It can look like a red bump under the eyelid or at the base of the eyelashes, and it can feel painful and tender. Most styes last about a week and will eventually heal without treatment.

When to Visit an Eye Doctor

It is not necessary to visit your eye doctor at the first sign of eye irritation, but if symptoms persist or worsen over 24 hours, or if you are a contact lens wearer and have a red eye for more than one day, you should make an appointment with an ophthalmologist. Here are a few symptoms that could indicate a serious eye infection:

  • Swelling in the area around the eyes
  • Sensitivity to light
  • Blurred vision
  • Eye pain
  • Discharge that forms a crust along the lash line
  • Blurry vision
  • Extreme light sensitivity
  • Sensation of a foreign object in the eye

Most eye infections can be prevented with good hygiene. Wash your hands often and avoid touching your eyes. Clean all towels, washcloths and pillowcases in hot water, and never share cosmetics. 

Herniated Disc Pain Often Relieved with Non-Surgical Treatment

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A herniated spinal disc can be extremely painful and can have a significant impact on a person’s quality of life. When a disc is herniated or ruptured, the gel-like, inner substance can leak into the surrounding area and aggravate the spinal nerves.

Fortunately, though, many people with pain from herniated discs experience relief from non-surgical treatment. If you have been diagnosed with a herniated disc, here are some of the non-surgical treatment options your orthopedic surgeon may offer:

Short-Term Non-Surgical Treatments for Herniated Disc Pain Relief

  • Ice: Pain and inflammation often accompany a herniated disc. Your orthopedic surgeon may recommend an ice pack to reduce swelling. After 48 hours, treatment with ice is less effective, so use it soon after the onset of back pain for optimum relief.
  • Heat, or heat and ice: For some, heat or a combination of heat and ice is the best short-term solution to relieve herniated disc symptoms. Like ice, however, treatment with heat is less effective after the first 48 hours.
  • Pain medication: As an initial non-surgical treatment for herniated disc pain, your orthopedic surgeon may recommend a non-steroidal anti-inflammatory drug (NSAIDs) such as ibuprofen to help relieve pain and reduce inflammation. Long-term use of NSAIDS has been linked to cardiovascular and gastrointestinal problems, so limit your use of these medicines.
  • Steroids: Another non-surgical option for herniated disc pain is steroids. Your orthopedic surgeon may prescribe an oral steroid to help you. Like NSAIDs, they should not be used over the long term.
  • Muscle relaxants: Some people with herniated disc pain experience painful muscle spasms. If this is true for you, your orthopedic surgeon may prescribe a muscle relaxant that can help.

Long-Term Non-Surgical Treatments for Herniated Disc Pain

  • Physical therapy: Spinal issues like herniated discs are often caused by weak back muscles. Because of this, your orthopedic surgeon may prescribe physical therapy, which can strengthen the back muscles reducing strain on the spine. Additionally, a physical therapist may teach you new and better ways to perform certain activities, such as lifting items, to help you avoid future herniated disc pain.
  • Epidural injections: Another non-surgical treatment to relieve herniated disc pain is an epidural injection, which contains powerful anti-inflammatory compounds. Epidurals are injected directly into the painful area to reduce swelling and bring pain relief.

Although there is a good chance a non-surgical treatment can help reduce herniated disc pain, it can sometimes take several weeks or months to establish a personalized treatment plan. Treatment will likely involve a combination of non-surgical methods.

If you have tried non-surgical treatments for herniated disc pain that have not helped or are no longer working, there may be a minimally invasive a spine surgery option that could benefit you. Talk to your orthopedic surgeon to find out more.

What is Celiac Disease and How is it Diagnosed?

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So, what is fact and what is fiction?

Gluten Intolerance Versus Gluten Sensitivity

Gluten intolerance is due to a condition called celiac disease. Celiac disease is a genetically predisposed autoimmune disorder in which the ingestion of gluten leads to damage in the small intestine. Common symptoms of celiac disease include brain fog, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue after eating gluten.

It is estimated that celiac disease affects 1 in every 100 individuals worldwide, but millions are unaware that they have the condition. In the United States alone, 2.5 million men, women and children have undiagnosed celiac disease. 

People who suffer from symptoms that seem related to gluten may have a condition referred to as non-celiac gluten sensitivity. This means that they may experience similar symptoms of celiac disease, but ingesting gluten does not damage their small intestine in the same way. Studies estimate that 18 million Americans have non-celiac gluten sensitivity. That is six times the number of Americans who have celiac disease.

How is Celiac Disease Diagnosed?

Celiac disease can be detected by a simple blood test that screens for celiac disease antibodies. The most common test is called the tag-IgA test. For this test to be effective, the patient must be eating a diet including gluten at the time the test is administered. If the blood test results suggests celiac disease, the doctor will make a referral to a gastroenterologist.

The gastroenterologist will perform an outpatient procedure called an endoscopic biopsy of the small intestine to evaluate whether the patient has tissue damage related to gluten. A diagnosis of celiac disease can be confirmed when there is evidence of healing due to a gluten-free diet.

If you are experiencing symptoms related to celiac disease, call your gastroenterologist for an appointment. 

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How Age-Related Macular Degeneration is Treated

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When the macula is damaged, central vision may appear dark, blurred or distorted. AMD is one of the leading causes of severe vision loss in the world among individuals over the age of 50.

AMD is a Worldwide Problem

One of the greatest challenges of AMD is that it is a multifactorial, progressive disease with no cure. There are two distinct types of AMD, wet AMD and dry AMD, and they behave differently. Currently, there are no tests that can identify risk or severity of AMD.

Available Treatments for Age-Related Macular Degeneration

Because there is no cure for AMD, the goal is to delay progression of the disease. In some cases of dry AMD, this can be accomplished with over-the-counter multi-vitamins that help protect the eyes from oxidative stress. Patients with wet AMD can benefit from eye injections that block the growth of new blood vessels in the eye. However, neither of these treatments restores vision.

Future of AMD Treatments

Clinical trials for AMD are large, lengthy and expensive, but researchers are committed to learning more about how and why AMD develops. A study was recently published online in Ophthalmology that suggests small particles in the blood could indicate the presence of AMD. This is particularly exciting because AMD can go undiagnosed for many years. The researchers were hopeful that blood profiles could help detect AMD earlier, thus preventing vision loss.

The Best Way to Preserve Your Vision

Yearly eye exams are the most effective way to detect AMD and preserve your eyesight. At your eye exam, your ophthalmologist will evaluate your vision for:

  • Eye diseases such as AMD, glaucoma and diabetic retinopathy
  • Refractive errors like nearsightedness, farsightedness or astigmatism
  • Focusing problems including presbyopia
  • Other vision problems such as strabismus, amblyopia or binocular vision

Eye exams can also offer a window into your overall health and detect chronic conditions like hypertension or high cholesterol. If it has been over a year since you have had a full eye exam with dilation, contact your ophthalmologist to set up an appointment.

How to Know if You Have a Gluten Allergy

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Gluten is what provides the elastic texture of bread, and it helps certain foods maintain their shape. Think of it as the “glue” that holds food together.  

Gluten can be harmful to those with Celiac disease because the protein causes inflammation and damage to the small intestine, the location in which the body absorbs vitamins and essential nutrients from food. Malabsorption can result in malnutrition, weight loss, anemia and stunted growth.

Gluten Intolerance Symptoms

There are over 200 identified symptoms of celiac disease, which means that every case is unique. An estimated 1 percent of the U.S. population is allergic to gluten, but 83 percent of those individuals are undiagnosed.

So how do you know if you may be allergic to gluten? Some of the most common symptoms include:

  • Abdominal pain
  • Gas
  • Bloating
  • Diarrhea
  • Nausea
  • Feeling tired or foggy
  • Migraine headaches
  • Dizziness and feeling off-balance
  • Inflammation, pain or swelling in your joints
  • Anxiety, depression and mood swings
  • Hormone imbalances
  • Diagnosis of chronic fatigue or fibromyalgia

How Gluten Allergy is Diagnosed

Many digestive conditions can present similar symptoms, so it is important to make an appointment with your doctor or gastroenterologist for proper testing. Celiac disease cannot be diagnosed by answering an online questionnaire or by eating a gluten free diet.  It must be diagnosed by a healthcare professional through a blood test.

There are several types of blood tests that screen for celiac disease antibodies, but the tTG-IgA test is the most common. For the test to be effective, you must be consuming gluten. If celiac disease antibodies are present in your blood, your doctor may order a biopsy of your small intestine to confirm whether you are allergic to gluten.

Non-Celiac Gluten Sensitivity

Some people experience symptoms of a gluten allergy but do not have celiac disease. This is often known as non-celiac gluten sensitivity. Although the two conditions share similar symptoms, non-celiac gluten sensitivity does not cause intestinal damage. Research estimates that 18 million Americans have gluten sensitivity, six times the number of Americans who have celiac disease.

Make an Appointment with Your Doctor

Remember that celiac disease is a serious medical condition. If you have symptoms, do not ignore them. Make an appointment with your doctor. Working with your primary care physician, a board-certified gastroenterologist and a registered dietician can help you obtain an accurate diagnosis and prompt treatment.

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