OrthoArizona Now Offering Outpatient Anterior Hip Replacements in Phoenix

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Dr. Michael Wilmink of OrthoArizona is leading the minimally invasive approach of how hip replacements are done.

Hip replacements are notorious for being complex with an overnight stay at the hospital.  The surgeons at OrthoArizona have now taken the next logical step with refinement of this procedure to allow patients to have their hip replaced at Gateway Surgery Center and go home the same day.  Patients are able to leave the surgery center approximately 3-4 hours after their surgery, walking with a walker and ready to start their rehabilitation.

Click here to read the full article.

A Healthy Gut Could Improve Joint Replacement

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Healthy intestinal bacteria could improve knee and hip replacement outcomes, but unhealthy gut bacteria could increase the risk of infection.

Good Gut Bacteria Prevents Joint Replacement Infections

A new study at the College of Engineering and the Hospital for Special Surgery (HSS) at Cornell University claims gut health directly impacts the risk of contracting an infection during surgery. The research team performed knee replacements on mice and discovered the mice with unhealthy gut bacteria were more susceptible to infections.

The testing is still in the early stages, but the team believes their study may have significant implications for human joint replacement surgery. More than one million Americans schedule a hip or a knee replacement each year. Although post-surgical infections are rare, infections are a leading cause for replacing an artificial hip and the number one cause of replacing an artificial knee.

How You Can Improve Your Gut Bacteria

Improving the gut microbiome could become an important component of prepping for joint replacement. There are many ways patients can improve their gut health. Some of these include:

  • Increasing fiber intake
  • Selecting foods and beverages with high levels of polyphenols (seeds, nuts, berries, olive oil, coffee and green tea)
  • Eating a variety of probiotic-rich foods like kimchi, miso, sauerkraut and pickles
  • Drinking kombucha and kefir
  • Avoiding antibiotics or medicines that eliminate healthy bacteria
  • Avoiding processed foods and artificial sweeteners

Talk to Your Doctor

Talk to your doctor about how you can cultivate healthy gut bacteria. By making some changes in your diet, you can boost your immune system, prevent infection and improve your overall wellness.

Can Cholesterol-Lowering Drugs Prevent Glaucoma?

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A recent study published in JAMA Ophthalmology found statins, a type of drug that lowers cholesterol, could help prevent primary open-angle glaucoma, or POAG.

Doctors often prescribe statins to patients with high cholesterol to reduce the risk of a stroke or a heart attack, but statins could have another benefit. A research team from Brigham and Women’s Hospital claims using statins for five years or longer could lower the risk of primary open-angle glaucoma, the most common type of glaucoma.

What is Glaucoma?

Glaucoma is a family of eye diseases in which elevated eye pressure, or intraocular pressure (IOP), causes optic nerve damage and can lead to progressive, permanent vision loss. Since glaucoma often has no symptoms in the early stages, it is very challenging to diagnose. The Brigham and Women’s study suggests statin drugs can lower IOP and enhance blood circulation to the optic nerve, thus preventing  POAG.

Jae Hee Kang, Sc.D., an assistant professor of medicine at Brigham and Women’s Hospital, and a team of researchers followed more than 136,000 healthy men and women aged 40 and older. Between 2000 and 2015, the team identified 886 individuals with primary open-angle glaucoma. The results indicated using statins for five years or longer is associated with lowering the risk of POAG by 21 percent, compared to not using statins.

Kang is hopeful about the prospect of broadening the use of statins beyond cardiovascular health. She says statins could also enhance neurological function in the eyes and prevent optic nerve damage. However, the results of the study do not suggest individuals with a family history of glaucoma should take statins to prevent developing POAG. Statins may have negative side effects, especially in older adults.

Practical Ways of Preventing Glaucoma

If you are not taking statins, there are many ways you can prevent glaucoma by making healthy lifestyle choices. According to the Glaucoma Research Foundation, you can:

  1. Exercise daily — Include daily moderate physical activity in your schedule. Studies show moderate exercise like walking, swimming, biking or yoga can lower your eye pressure. You should try to avoid inverted yoga poses like headstands or downward-facing dog, as these poses may cause spikes in eye pressure.
  2. Eat a healthy diet — A diet high in fruits, vegetables, whole grains, lean proteins and healthy fats will help nourish your eyes with essential vitamins, minerals and antioxidants. It will also help you maintain a healthy weight.
  3. Protect your eyes — Eye injuries can cause glaucoma, so wear proper eye protection when you are using power tools, sports equipment or lawn equipment.
  4. Visit your eye doctor regularly — Glaucoma affects about three million Americans, but only half are aware they have the disease. Yearly comprehensive eye exams are essential for optimum eye health and disease prevention. Call your eye doctor to make appointments for the whole family.

Anyone can develop glaucoma, but some people are at higher risk than others. Take a Glaucoma Risk Assessment to determine your glaucoma risk.

Met Your Deductible? Schedule an End-of-Year GI Procedure

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Your elective GI procedure could be the most affordable at the end of the year after you have met your healthcare deductible.

What is a Healthcare Deductible?

Your annual healthcare deductible is the amount you must pay for covered medical procedures before your insurance company begins to contribute. One of the best ways to stretch your healthcare dollars is to schedule elective procedures after you have met your annual deductible. It’s almost the end of the calendar year, so if you haven’t maximized your health insurance benefits, now is the time.

Most deductibles reset on January 1, so evaluate whether you should schedule a recommended, routine procedure, like a screening colonoscopy before December 31. If you meet your deductible, your out-of-pocket responsibility for an elective GI procedure could be considerably less.

Get the Most Out of Your Health Care Plan

Here are five tips to help you get the most out of your health plan.

  1. Talk to your doctor about what GI procedures and tests are necessary or recommended. Obtain the procedure codes.
  2. Call your health insurance provider. Ask if you have met your deductible or if you are close to meeting it. Using the procedure codes from your doctor, request an estimate of costs for diagnostic tests, lab work and outpatient procedures so you can prioritize your spending.
  3. If you have a Flexible Spending Account (FSA) through your employer, call the customer service number on the back of your card or log into your account to check your balance. FSA funds do not roll over into the following year, so plan to use your FSA money on a GI procedure if you need one.
  4. Consider carefully before using Health Account Savings (HSA). HSA contributions do not expire like FSA contributions. You can accumulate HSA funds and save them for a future elective procedure, so use your HSA after you have depleted your FSA.
  5. Do not delay scheduling preventive screenings like colonoscopies. Medicare and most private insurance cover preventive tests. If you do not have a family or personal history of colon cancer, most screening colonoscopy procedures (including anesthesia and sedation) are covered at 100 percent.

Set aside a few hours to call your doctor, insurance provider and FSA or HSA account provider. These calls will not take as long as you might think, and they could save you thousands of dollars.

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Lead Exposure Could Increase Your Risk of Glaucoma

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POAG develops when the inner-eye fluid, called aqueous humor, does not drain properly. Gradually, eye pressure builds to dangerous levels and can cause optic nerve damage and permanent vision loss. This eye condition is complicated because it is incurable, and vision loss is permanent and irreversible.

For years, researchers have linked glaucoma to a combination of risk factors including age, heredity, medication and health history. This study is unique because it suggests your environment could affect glaucoma risk.

Bone Lead Levels Affect Glaucoma Risk

Oxidative stress can elevate eye pressure and damage the optic nerve. Sung Kyun Park, an environmental health scientist at the University of Michigan, led a study on lead exposure and oxidative stress. Park wanted to learn whether chronic lead exposure affected glaucoma risk.

Because blood tests only measure recent exposure to lead, they were inadequate to analyze long-term contact with lead. Park decided to measure lead levels in the knee and leg bones because bones store lead for decades.

Park analyzed patella and tibia lead levels from a subset of participants in the VA Normative Aging Study, a study that has followed 2,280 men since 1963. The research team tracked ophthalmologic and bone lead level data on 634 men and identified 44 new cases of primary open-angle glaucoma (POAG).

Park estimates POAG risk was about “five times higher with a 10-fold increase in patella lead and about three times higher with a 10-fold increase in tibia lead” (EHP).

Although this research found strong evidence linking long-term lead exposure and POAG, Park needs to conduct further studies. He wants to examine the effects of other metals on POAG, as well as exposure at an early age.

Know Your Glaucoma Risk

According to the Glaucoma Research Foundation, more than three million Americans have glaucoma, but only half are aware they have the disease. It is imperative that you know your own risk for glaucoma. You are at higher risk for glaucoma if you are:

  • 45 years of age or older
  • African American
  • Nearsighted
  • Farsighted
  • Diabetic
  • Taking steroids (orally, injected or eye drops)

You can learn more by taking our Glaucoma Risk Assessment. In only a minute, you can find out whether you are at elevated risk for vision loss.

Finally, you can take active steps to preserve your eye health by exercising regularly and eating a diet high in fruits, vegetables, whole grains and lean proteins. Annual comprehensive eye exams with your ophthalmologist are essential to evaluate your eye health and overall wellness. If it has been over a year since your last appointment, call your ophthalmologist to schedule a check-up.

Hip Shape May Predict Total Hip Replacement

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Hip shape predicted the likelihood of whether patients needed total hip replacements in a recent study presented at the World Congress on Osteoarthritis.

Laura Laslet, Ph.D., is a musculoskeletal epidemiologist at the University of Tasmania in Hobart, Australia, who focuses on osteoarthritic pain. Dr. Laslet and a group of colleagues sought to identify risk factors that anticipated total hip replacement. Although hip pain and hip osteoarthritis are two main predictors for hip replacement, they are not the only indicators. Hip anatomy plays a significant role as well.

Hip Anatomy and Hip Dysplasia

The hip is the largest ball and socket joint in the body. Hip bone parameters, such as decreasing acetabular coverage, were among factors that predicted total hip replacement. The acetabulum, located in the pelvis, is the socket structure of the hip joint. The top part of the thigh bone called the femoral head is the ball. In a healthy hip, the femoral head fits securely into the acetabulum and rotates freely in the cartilage lining.

If the acetabulum does not fully cover the femoral head, the hip joint can become dislocated or partially dislocated. This is known as hip dysplasia. Dr. Laslet found that patients who had decreasing acetabular coverage had a higher risk of total hip replacement.

Risk Factors for Total Hip Replacement

Between 2002 and 2016, Dr. Laslet and her team analyzed 1,100 participants from 50 to 80 years of age from the Tasmanian Older Adult Cohort (TASOAC) Study. The team examined pelvic X-rays, bone density scans, MRIs and hip shape parameters. They looked at data from 40 patients who underwent hip replacements and 762 patients who did not. Patients were compared to others of the same gender, age and BMI.

The study identified other risk factors for total hip replacement, such as:

  • WOMAC hip pain (self-administered questionnaire on perceived hip pain, stiffness and physical functions)
  • Bone marrow lesions (areas of bone impaction and bleeding caused by trauma)
  • Impingements (abnormal friction during hip movement that damages the joint)
  • Irregular shaped femoral head
  • Osteoarthritis

No other study has considered all these predictors in the same set of data, says Dr. Laslet.

“Combination of measures may allow us to improve models predicting risk of total hip replacement,” Laslet concluded. “All of these things can only help us in finding ways to prevent and treat osteoarthritis. We have shown in our data that age, sex and BMI did not predict total hip replacement independent of pain and hip osteoarthritis” (Healio).

Hip Treatment Reduces Risk of Other Injuries

If you are experiencing hip pain or reduced mobility, call an orthopaedist for a consultation. Limited hip flexibility can place more stress on other structures and can make them more susceptible to injury.

Ask Your Doctor for Cancer Screening Tests

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A recent study published in JAMA Network Open discovered primary care physicians (PCPs) are more likely to order cancer screening tests for patients with morning appointments rather than afternoon appointments. This is partly due to “decision fatigue,” the result of the summative burden of screening discussions in earlier appointments, and doctors falling behind as their shift progresses.

The study analyzed data from 33 primary care practices in New Jersey and Pennsylvania between 2014 and 2016. Clinicians ordered colon cancer screening tests for 37 percent of eligible patients with 8 a.m. appointments but only 23 percent of patients with later afternoon appointments.

Results were also consistent for breast cancer screenings. Doctors ordered mammograms for 64 percent of eligible patients with 8 a.m. appointments but only 48 percent of eligible patients with 5 p.m. appointments.

The study proposed three reasons why doctors suggested cancer screenings less often in the afternoon:

Decision Fatigue

Decision fatigue, defined as the depletion of self-control and active initiative, happens in every profession, and doctors are no exception. Doctors must make countless decisions regarding patients’ health. As the day goes on, physicians are more likely to forego a cancer screening discussion because they have already initiated these conversations earlier in the day.

Falling Behind in Scheduled Appointments

Appointments at the end of the afternoon tend to be shorter because doctors often are behind schedule. One way to abbreviate patient visits is to address the reason for the appointment only and delay the cancer screening discussion for next time.

Conserving Mental Energy

If morning patients decline cancer screenings, doctors may be less likely to suggest cancer screenings for patients with later appointments. The brain is very good at conserving energy, and meeting with resistance causes the brain to find more accessible pathways. In this case, the easier pathway would be to avoid suggesting the screening.

What kind of conclusions can we draw about doctors’ judgment during afternoon appointments? Are all afternoon appointments a waste of time? Not at all.

Perhaps we can view this data from a different angle. Decision fatigue can affect anyone of any age or profession, from a quarterback at the end of a game to a criminal judge, or even a mother of toddlers.

Making repeated healthcare decisions is exhausting, and doctors willingly carry a heavy yoke of responsibility. Deciphering symptoms, diagnosing illnesses and prescribing care erodes physical and mental energy as the day continues. Instead of passively relying on your doctor to suggest the preventive screenings and tests for which you are eligible, you can be proactive and do a little research for yourself.

Before your next well appointment, call your insurance company and ask what screenings and tests are recommended for your gender and age. You can also ask about whether you have met your deductible for the year and get an estimate for any out-of-pocket charges you may incur for the recommended screenings.

As an informed patient, you can make the most of your doctor appointment by:

  1. Bringing a list of recommended preventive screenings.
  2. Writing out any questions you may have.
  3. Asking your doctor’s recommendation regarding specific tests (colonoscopy vs. stool test).

Remember, you are the best advocate for your health, so don’t wait for your doctor to initiate the conversation about vital routine screenings. Bring up the subject yourself and be proactive about your care.

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Waldorf Endoscopy Center Staff give back to Special Olympics

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It was such a fulfilling and rewarding experience and during her time volunteering, she spoke with the Coordinator for the Sheriff’s Dept., Sgt. Gus Proctor about other ways to support the Special Olympics-the Torch Run was brought up. She then spoke with the staff on their interest and they decided to order t-shirts. Sgt. Proctor delivered them and the group photo was taken. 

Each year the Charles County Sheriff’s Office sponsors several fundraising events in support of the Special Olympics of Maryland. One in particular is the a Law Enforcement Torch Run for Special Olympics which will take place June 6,2019 in LaPlata, Maryland, of which center staff will attend. The Run is 3.5 miles for runners or 3 miles for walkers. This is a family event that raises money for the Special Olympics and by purchasing the Torch shirts, the money raised will help Special Olympics of Maryland.

Esophageal Research Center Opens with Help from the Kardashians

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The Robert G. Kardashian Center for Esophageal Health is the newest addition to the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases. The center is a collaboration of UCLA’s experts in gastroenterology, oncology, anesthesiology, surgery, pathology, radiology and pediatrics, all dedicated to the prevention, diagnosis and patient-centered treatment of esophageal diseases.

Robert Kardashian was a prominent businessman and lawyer from Los Angeles. He is most remembered for representing O.J. Simpson in his 1995 trial, and for being the father of Kim, Khloe, Rob and Kourtney who are on the television series Keeping Up with the Kardashians. Mr. Kardashian was diagnosed with esophageal cancer in July 2003 and died just two months later, at age 59.

Kim Kardashian West and her mother, Kris Jenner, along with other family members, attended the ribbon-cutting ceremony honoring her late father. After the event, Kim tweeted, “So proud to announce the Robert G Kardashian center for esophageal health being launched at UCLA. My wish is that other families can have more information and we can also focus on health and prevention.”

What is Esophageal Cancer?

Esophageal cancer begins when cells in the esophagus mutate and divide abnormally. This cancer is the sixth-leading cause of cancer death in the world because it is fast-growing, aggressive and has few symptoms.

Incidence of esophageal cancer and esophagus disorders has increased dramatically in the past decade. Risk factors include alcohol and tobacco use, obesity, poor nutrition and gastroesophageal reflux disease (GERD). Chronic acid reflux damages the lining of the esophagus and can cause a condition called dysplasia, which increases the risk for Barrett’ esophagus, a precursor to esophageal cancer.

How to Lower Your Risk for Esophageal Cancer

You can take proactive steps to lower your risk for esophageal cancer by adopting healthy lifestyle habits.

  1. Eat a well-balanced diet with lots of fruits, vegetables, whole grains, lean proteins and healthy fats.
  2. Limit your alcohol intake and drink only on special occasions.
  3. Quit smoking and do not use tobacco products.
  4. Visit your doctor annually for well visits.
  5. Say “yes” to all preventive screenings. Preventing disease is always more cost-effective than treating it.
  6. Call your doctor if you notice symptoms of an esophageal disorder which include heartburn, difficulty swallowing, indigestion, chest pain, persistent coughing, hoarseness, throat burning or weight loss.

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