Get out and enjoy some free Vitamin D!

Sunshine isn’t only good for uplifting the soul, it is also good for your bones! You cannot find a better natural source of Vitamin D than sunlight. Vitamin D is necessary for your body to absorb calcium, which makes our bones strong. The best time of the day is between 11am and 3pm. As you well know, the weather in Josephine County can be sunny one hour and raining hard the next. Paragon Orthopedics wants its patients to have the healthiest bones they can. Increase your Vitamin D, enjoy the sunshine today, and keep those bones strong!

PRP: Can it help me avoid surgery?

Paragon Orthopedics here in Grants Pass publishes monthly informational newsletters. Coming up in April will be the newest information about Platelet Rich Plasma therapy, which supplements the body’s repair process and sometimes helps a patient avoid invasive surgery. Sign up to receive the newsletter via email at Paragon Orthopedic Center and stay tuned to our blog!

Dr. James Van Horne of Grants Pass making big headlines about a new post-op protocol minimizing opioid use

With narcotic usage up in Josephine County, Dr. Jim Van Horne is trying to do what he can to change this, and his research is proving highly beneficial to reducing the need for drugs in post-operative total joint arthroplasty. Check out this article.

Now Trending….Activated Charcoal

Paragon Press

Are the benefits real?
The substance once only known for treating accidental ingestion of poison is now popping up in everything from toothpaste to ice cream. Some label it a “detoxifier.” Getting rid of toxins might sound appealing. Is this black stuff okay to use and eat?

WHAT IT IS: Activated charcoal is made by taking plant materials rich in carbon, such as wood or coconut shells, then heating them at very high temperatures. The “activation” comes from stripping the substance of previously absorbed molecules, making them able to bind again. The resulting charcoal absorbs various substances, depending on the application. As a side note, this is not the same as food that has been burned in the process of cooking. The problem is that activated charcoal doesn’t discriminate. It will bind to any substance it meets, whether it is medicine, or the vitamins and minerals found in your food. When ingested, the charcoal itself is not absorbed by the body.

WHAT IS KNOWN: The only approved use of it is for poisonings. The claims being made by trendy products right now are based on its chemical properties and potential. No major research has been done to back any other applications of activated charcoal.

THE CLAIMS: Some of the claims out there right now are for: skin cleansing, deodorants, water filtration, neutralizing intestinal gas, improving kidney function for those with kidney disease, whitening teeth, and wound care. As far as its detoxifying properties, activated charcoal binds to things in your stomach and small intestine. It cannot remove built up “toxins” found in your body. “Detoxing” is a buzz word these days, but this method of detoxification can be detrimental to your health if you don’t know the risks of it absorbing medications, vitamins, and minerals. No evidence exists to support its abilities to cure hangovers either. When used in foods, some have noted it turned their mouths a shade of gray. This probably is not the best choice if you’re on a first date.

WHAT’S NEXT: Look for continued research on this activated charcoal. Education is the key. New York City has placed a ban on using it in food and drinks, even though the FDA has not specifically banned it…but they also have not approved it. If you are considering ingesting this for any purpose, check with your healthcare provider first, as it might interfere with absorption of your medicines and nutrients in your food.

The following articles were referenced for this newsletter:

Is Smoking Marijuana Dangerous?

It is impossible miss how marijuana is impacting our lives and towns. It is becoming increasingly legal; 33 states have legalized medical use and 10 states have legalized its recreational use so far. As it becomes more acceptable, research is trying to keep up with the consequences of this drug. Here are some highlights.

The number of heavy cannabis users is up. By 2017, there were about 8 million Americans who reported using it at least 300 times in a year, which is considered to be daily use. It is true that the cannabis grown today is far more potent than that of the ‘70’s, with more THC. THC, or delta-9-tetrahydrocannabinol, is the chemical that produces the “high” or psychoactive results. Today’s marijuana is 20-25% THC, compared to less than 2% in that of the 1970’s. This is due to complex cloning and farming techniques. As far as the CBD content, which is what some desire for the medicinal effects, this concentration is declining. What does this mean? It means that you’re going to get a stronger effect on the brain or high, resulting in a higher chance of THC toxicity. If you’re using it for the CBD effects, you will get less of its medicinal properties. There has also been an increase seen in the contaminants found in the plants. All of this points to inadequate regulation because there isn’t any content labeling. The grower can tell you anything. The United States does not have a system to track mental illnesses like they do other diseases, so there isn’t any hard evidence to say psychotic events are increasing, but studies show marijuana use is a significant risk factor for psychotic episodes and violence. In addition to large studies of people on this, there are also statistics from the first four states to legalize recreational marijuana. These states showed combined significant increases in murders (38%) and aggravated assaults (25%) after legalization, compared to the national average (20% for murder and 11.5% for aggravated assault). Our society has stereotyped pot-users to be oblivious couch potatoes, but the hard data connecting marijuana to violent behavior goes back 150 years to asylums in India.

Knowledge is crucial if you are using marijuana or are considering it. At this point, there is not regulation to give consumers the information to know exactly what is in what you purchase. The risks can be significant and long-lasting. Think about how it took decades before cigarettes and alcohol were studied and education about the dangers began with labeling and regulation. A similar approach is necessary for marijuana, even for medicinal use. Actual medicines have research to list the benefits, risks, and appropriate dosages. Marijuana does not meet any of these standards, hardly making it trustworthy medicine. It impairs judgement, damages the respiratory tract, and increases the risk of psychosis. Just because modern medicine cannot treat everything satisfactorily, it does not mean marijuana is the answer. Don’t kid yourself into thinking it’s safe.

At Paragon we strongly suggest that you eliminate smoking marijuana before and after surgery at a minimum.

The following articles were referenced for this newsletter:
Happy Valentine’s Day from Paragon Orthopedics!

Paragon Press – December 2015

What is DOMS – The mystery of pain “out of nowhere”?

Your goal to work out four to five times a week starting January 1st is made and you head off to the gym to begin Day 1, for a healthier 2016. The first day begins with a moderate upper body lifting regimen. You decide not to work out the next day, but when you wake up on the third day, you can barely lift your arms to get in a spoonful of cereal. What happened? Why didn’t I hurt yesterday if this is from lifting weights? Is it an injury?

The usual answer is: no. You are experiencing DOMS, or Delayed Onset Muscle Soreness. Delayed soreness can develop 12-24 hours after you exercise, with the greatest pains happening in up to 24-72 hours. This pain stems from microscopic damage done when you placed new stresses on the muscles. This damage is not permanent; it is a side effect to the repairs your body is doing, which can lead to stronger muscles and increased mass. There are certain activities known to cause DOMS:

  • Step aerobics
  • Strength training exercises
  • Hill walking
  • Jogging
  • Jumping

These activities cause muscles to lengthen when force is applied, leading to the microscopic damage, and the delayed pain you will experience. The amount of DOMS pain you have depends on the type and amount of force placed on the muscles. For example, running down a hill places greater force on a muscle than walking down the same hill, resulting in more pain after the downhill run. Doing more repetitions results in more pain than less. This is the reason doctors and exercise experts recommend you start slowly.

I Think I Need Help

DOMS typically does not require you to seek medical treatment. If the pain becomes debilitating, your arms or legs become swollen, or if your urine becomes dark, then you should seek medical attention.


Starting slowly into a new exercise routine is the first step to avoid DOMS. Include a cool down period of 10 minutes after exercising, raising your heart rate mildly, such as slow jogging and stretching. Allow enough time for your muscles to recover before using those aching muscles. Schedule your workout routines to cover a variety of muscle groups on different days, so you don’t stress the same group every time. Stretching before and after the exercise can help. Know that everyone can get DOMS, from the exercising newbie to the track Olympian. Let that soreness encourage you that you are working your muscles and creating a healthier body.

The following articles were referenced for this newsletter:


Paragon Press – June 2015

Can My Medications Hurt Me During Surgery?

If you have had surgery, you more than likely were told not to eat or drink after midnight the night before surgery, except for one or two medications taken with a small sip of water in the morning. The surgeon needs to know exactly what you are taking to know what pills are vital to your health and those that cannot be skipped. Wait…there are more reasons to be very thorough when making that list. Read about these commonly used medications to understand more fully how they impact your body during surgery.When you go in for a healthcare-related appointment, you usually fill out paperwork listing all your medications. You might not be very careful to list every single last one, but did you know it is crucial to list every prescribed and unprescribed medicine when you go in for orthopedic surgery? Your surgeon needs to know each drug you take, its dosage, and what it does for you in order for your surgery to have the best outcome possible. Your primary care physician should be able to give you a complete list of prescription medications to take to your surgeon, and don’t forget about anything bought over the counter that you take.

DID YOU KNOW? Nearly 70% of Americans are prescribed at least one medication.

Blood Pressure Medications: These are usually continued the day of surgery to maintain your regulated blood pressure. If your medication and blood pressure have not been stabilized prior to surgery, it could mean a delay for your procedure. A stable blood pressure is a must before undergoing any surgical procedure.

Diabetic Medications: Because the stress of surgery can lead to higher blood glucose levels, your insulin might need to be adjusted for surgery. Some oral diabetic medications may need to be stopped before you are given anesthesia.

Blood Thinners: In most case, these need to be stopped 5-7 days prior to surgery. Your surgeon will let you know how soon to stop taking them and when to resume them. The reason for this is thinners cause extra bleeding that could cause swelling or an infection at your surgical site.

Steroid Medications: To maintain your body’s steroid levels, which are important for blood pressure regulation, these are usually continued the day of surgery. If your steroid level drops, it could lead to low blood pressure problems during surgery. This is dependent on what levels of steroids you take, so be specific about your dosage with your surgeon.

Heart Medications: These are normally continued the morning of surgery, taken as usual. A thorough heart history is necessary before surgery. Sometimes, additional heart medicines, called beta blockers, are added to decrease the risk of any heart problems during surgery.

Dietary Supplements: Some over-the-counter supplements can interfere with medications necessary for your surgery. Other over the counter substances can cause surgical bleeding. Taking them can lead to complications, so be thorough about reporting them all.

Immunosuppressant Medications: If you are a transplant patient, or have an inflammatory condition, such as arthritis, the immunosuppressants you might be taking could significantly slow wound healing after surgery. Have a discussion with your surgeon about temporarily stopping these.

Understanding the impact of medications on your body’s processes gives more insight into your surgeon’s need to know in advance. Always be detailed about anything you are taking for the best surgical outcome.

The following articles were referenced in making this newsletter:

Preparing for surgery, medication checklist; why the surgeon needs to know about them

Paragon Press – May 2015

Start off the Summer Season with a New Exercise Program

The American College of Sports Medicine’s 10 tips

The warmer days are arriving. Exercise is on many people’s minds, but they lack a trigger to get started, or just don’t know how to begin getting in shape. Paragon Orthopedics sees many patients who have regrets about not being in better shape after a serious injury. To help you, here are a few pointers from the American College of Sports Medicine to create an active exercise plan that gets you excited to begin!

1-Get to know your body.

Without knowing the basics of your muscles and how they work together, you might be putting yourself at risk for injury. The internet is full of information on the basic muscles used in exercising. Know the difference between good pain, from working your muscles harder, and bad pain, from joint problems or a ligament tear. Rest and stretching are sometimes what is needed, instead of trying to push through pain as you start a new program. Some health clubs have trainers to help you distinguish good pain from bad pain.

2-Understand why you are exercising.

Ask yourself, “Why did I begin to exercise?” This clarity helps you stay positive and stick with the exercise program. Mental motivation can act as fuel to experience more positive effects.

3-Assess your current fitness level before starting.

For example, write down your pulse rate before and after walking a mile; count how many push-ups you can do in 30 seconds; and measure your waist circumference. You can’t know your progress unless you have a starting point.

4-Set mental goals.

Have in your mind a realistic picture of what being in good shape can be for you. These positive thoughts will propel you toward your goals.

5-Identify activities that will help you attain your fitness goals.

Choose activities that interest you, not just what you see others doing. If running is boring, don’t plan on using the treadmill. However, if you enjoy the camaraderie of a spinning class, or prefer the weightlessness of swimming, use these activities to take you to your new fitness level.

6-Develop a comfortable routine.

The ACSM recommends adults have at least 150 minutes of moderate to intense physical activity every week. Build the exercise into your daily routine. Don’t overdo it, especially in the beginning, but don’t do too little. Start out with something that feels comfortable and increase from there. Recognize what has stopped you in the past from sticking with a routine. Listen to your body.

7-Write it down!

Organize your daily and weekly goals on paper. Those who write down their goals can accomplish up to 16% more than those who don’t. Some people have found success using computer programs that monitor your progress, but if the thought of this makes your plan feel more complicated, go with paper and pencil.

8-Have the correct equipment to make exercise enjoyable.

Purchase those water weights or new walking shoes that don’t hurt your big toe. If you are more motivated with music, compile a soundtrack with your favorite songs. Studies show music is a really good motivator for longer and more vigorous exercise.

9-Create incentives.

Develop a reward system before you begin your new plan, and make the rewards realistic.

10-Get started and feel confident.

After all that preparation, you should feel motivated to put your plan into action. Know improvements will take some time and give yourself several months to see an impact. Trust you have developed a great plan and can see it through for success!

All of this might sound like a lot of work, but studies have shown that the clarity of having a plan produces better fitness results. Always consult a therapist or doctor before you begin if you are already being monitored for health conditions. Don’t be afraid to reset your goals to keep your plan realistic, especially if you’ve had a setback. Maybe you set your goals too high and you’ve found the plan to be overwhelming. Reassess and create something you can stick to doing. If an activity has become boring, switch the plan to one that makes you more interested.

Get started today!

The following articles were referenced in making this newsletter:

Paragon Press – April 2015

Overuse Injuries

Overuse injuries once only developed in professional athletes, but today we see it in children, largely as a result of sports specialization and excessive play. Even weekend warriors who do too much at once are prone to these. Here are some tips to keep in mind for you, your kids, and your grand-kids:

  • Playing one sport year-around doesn’t allow for a period of rest. Give those stressed joints a break and take a few weeks off between seasons.
  • Don’t allow a coach to overuse a child during one game or tournament.
  • STRETCH, STRETCH, STRETCH…like taffy, muscles want to be warm to move easily.
  • Keep a balanced approach. Playing more than one sport allows different muscles to be used, thus making new muscles be used and others to not feel so much stress.

Name That Tuna

Canned tuna is the second most popular seafood product in the U.S. after shrimp. This protein-packed food, which keeps in the can for 4 years, is a great source of vitamin B-12, vitamin D, calcium, and iron. If you have been to the grocery store lately, you might wonder which type is best for you. Is white better than light? What’s the difference between solid and chunk? Why are some packed in oil and some in water? We will try to demystify these terms and help you feel confident you are buying what’s best for you and your family.

Solid or Chunk?

“Solid”, or “Fancy,” is a fish that was packaged as a whole piece, whereas “Chunk” means the piece has been broken into pieces. It’s a matter of texture preference.

White or Light?

A label that indicates “white” tuna is the albacore variety only. This fish is a more mild-flavored fish with a firm texture. Because it is the truest white meat of the 7 tuna varieties, it is more expensive and considered “premium.” Albacore also contains more omega 3 fatty acids than light tuna, 808mg per serving, versus 239mg in light. Consider this: Canned albacore is higher in mercury and more expensive than canned chunk light tuna.

Oil packed vs. Water

Fats carry flavor, so tuna packed in oil will have a fuller flavor and more appealing mouth feel. However, if you’re concerned about fat content, water-packed tuna has only 0.75g of fat per serving, as opposed to 6.9g for oil-packed. Water-packed tuna is a great, lean protein source.

The following articles were referenced in making this newsletter:

Paragon Press – February 2015

THE NEW YOU FOR 2015: Essential information you and your health

Save your money: Skip the vitamins

The commercials make you think you aren’t as healthy as you could be unless you take them. However, study after study has shown no ability of vitamins to increase your lifespan, or decrease your chances of fighting a chronic disease. According to researchers at Johns Hopkins and other institutions, eating a healthy, well-balanced diet gives you all the nutrition you need. They discovered even more: taking certain supplements can increase your risk of death. Additional beta carotene, vitamin E, and vitamin A are considered useless and potentially dangerous. Even though you might be in the habit of taking that vitamin with your orange juice every morning, in light of this news, you’d be better off spending your money on more fruits and vegetables.

Switching to diet soda isn’t a guarantee for weight loss

Regular soda contains many empty calories: about 140 calories per 12oz can. People automatically think switching to diet soda, with virtually no calories per ounce, will make them lose weight. Did you know that new research shows overweight adults who drink diet sodas are likely to compensate by eating more food, thus resulting in no weight loss? A study published in the American Journal of Public Health showed obese/overweight adults drinking diet sodas consumed more calories at mealtimes and when snacking compared to obese/overweight adults who consumed sugary beverages. If you switch to diet soda for weight loss, you need to also eat less. It would be smart to look at other areas in the diet where empty calories are consumed, such as candies and gum, and adjust eating habits as well.

How healthy are those freeze-dried snacks?

Freeze-dried fruits and vegetables are a trendy way to sneak in vitamins and minerals these days, but are they really that good for you? Technically, companies have just taken the only the water out of the food, but unfortunately, they sometimes add sugars to make them taste better. These hidden calories can add up in a day. Also, snackers might find some abdominal discomfort because of their concentrated fiber. It’s easy to eat 20 dried apple slices, but think about how much that would be if it wasn’t dehydrated. Despite these downsides, the dehydrated snacks are much better for you than candies and sugary snack bars. Eat with moderation.

More sleep, a better you in 2015?

We’re a nation of sleep cheaters, trying to get more out of the day. If you’ve made a promise to get more rest this year, here are some tips to get quality zzz’s.

  • Exercise-Moderately, three to four times a week. Research has shown exercise improves sleep.
  • Limit caffeine-Don’t drink caffeinated drinks after 4pm. Research shows they disrupt sleep patterns.
  • Relax-Make it a habit to relax one hour before bed. That includes shutting off electronics, such as televisions and computers. The light from these can delay your sleep onset.
  • Control light-Keep your bedroom cool and dark, using a sleep mask, if needed.

The following articles were referenced for this newsletter:

Pierre, C.(Ed.). (2014). Diet Soda’s Downside. Johns Hopkins Health Review, 1(1).

Pierre, C. (Ed.. (2014). Skip Those Vitamins. Johns Hopkins Health Review, 1(1).

Pierre, C. (Ed.). (2014). Before You Pack Those Freeze Dried Snacks… Johns Hopkins Health Review, 1(1).

Richards, S. (2014). Cheating Sleep. Johns Hopkins Health Review, 1(1).