Paragon Press – July 2014

What You Can Do To Increase Your Chances of Successful Surgery

First, are you a good candidate?

You have an appointment with your surgeon and he tells you your problem requires surgery. You ask how soon it can be done, and he tells you he can’t do it, or even that he won’t do it. Nobody wants to be told they can’t have what they want, but surgeons realize with some patient choices, the chances of the surgery being successful are slim to none. A surgeon wants your surgery to be successful, just like you do, but did you know certain choices can make you a poor surgical candidate?

Two that are too risky

Statistics show that certain unhealthy behaviors make surgery less successful. Two behaviors which are frequently the cause of poor surgical outcomes are:

  • Smoking
  • Obesity

We would like to think we all heal the same, but studies show this is not the case. Factors such as age and preexisting health problems can be causes for failed surgeries, but they are beyond our control. There is a significant body of research that shows smoking and obesity can drastically decrease the chances of a successful surgical outcome and these are behaviors that a patient can change. Smokers and obese patients in England are being denied for in vitro fertilization, breast reconstruction, and new hip/knee surgery unless they slimmed down or stopped smoking.

Smoking

A recent study found in the Journal of Bone and Joint Surgery (JBJS) compared the clinical outcomes of nonsmokers, current smokers, and former smokers following knee surgery. The researchers concluded smoking had a negative effect on surgery and heavy smokers showed even worse outcomes. Patients who stopped smoking at least one month prior to surgery had the same outcome as a patient who never smoked. According to the American Association of Orthopedic Surgeons (AAOS), smoking may be the single most important factor in postoperative complications. Smoking complications include:

  • Poor wound healing
  • Infection
  • Less satisfaction in the final outcome of surgery

Broken bones take longer to heal in smokers because of the harmful effects of nicotine on the production of bone-forming cells.

Cigarette smoking is recognized as one of the major causes of preventable disease. Many people are very aware of how smoking affects your lungs, but not many know that it has serious negative effects on bones, muscles, and joints, and that smoking often leads to poorer surgical outcomes, especially in orthopedics.

Obesity

Two-thirds of the American population is considered overweight or obese. Study after study has shown the deleterious effects of obesity on a person’s health. Obesity is associated with over 60 medical conditions. Among the more studied are:

  • Cardiac fitness-Studies show the stress of surgery on the heart might increase the chances of a cardiac event or increase chance of death in an obese person.
  • Diabetes-In one study of diabetics, 28.3% developed post-operative complications after orthopedic surgery as a result of their diabetes.
  • High blood pressure-This can negatively affect cardiac function, as well as many other organs within the body.
  • Sleep apnea-According to Dr. William Mihalko of the Campbell Clinic at the University of Tennessee, obese patients with sleep apnea have higher complication rates after orthopedic procedures.

Obese patients tend to have poorer outcomes and the expense of treating them is much higher than that for non-obese patients. Complication rates for patients with a BMI over 40 (considered “morbidly obese” is 22%. Children are also included in all these warnings, since nearly one in three children is overweight or obese. Inactivity and obesity combined can take as many as 7 years off life expectancy.

This should open your eyes to what you can do for your health. If you struggle with your weight, it’s easier to take off the weight before arthritis occurs and makes it more difficult exercise. If you can quit smoking even just one month prior to surgery, you have increased chances of surgical success. Talk to your surgeon to make sure you are in the best position to have a successful surgery. Both of you want only the best!

The following articles were referenced for this newsletter:
http://jbjs.org/content/96/12/1007
http://orthoinfo.aaos.org/topic.cfm?topic=A00262
http://www.theguardian.com/society/2012/apr/28/doctors-treatment-denial-smokers-obese
http://www.generalsurgerynews.com/ViewArticle.aspx?d=Extended+Hernia+Coverage&d_id=478&i=January+2012&i_id=806&a_id=19990
http://www.aaos.org/news/aaosnow/apr13/cover3.asp
http://www.ncbi.nlm.nih.gov/pubmed/23479424

Paragon Press – June 2014

Ouch, My Elbow Hurts!

Tommy John surgery proves very successful; Why so many Elbow problems begin at young ages

Many people have elbow issues, especially at older ages, simply from overuse. Once the elbow discomfort reaches a point when you cannot function, surgery is considered. In the last 10 years, there has been a sudden increase in elbow surgery mainly in athletes, and of those, mostly baseball players. Baseball pitchers of every age are throwing harder and starting at younger and younger ages. These two factors alone add a lot of stress to a very delicate ligament in the elbow, known as the ulnar collateral ligament, or UCL. The surgery to reconstruct this ligament is called Tommy John surgery, named after the former major league pitcher who was the first to have this surgery. When the UCL is damaged, there is often pain and instability with throwing, thereby making accurate, fast pitching impossible. This can be corrected with surgery, where the ulnar collateral ligament is replaced with a tendon from elsewhere in the body. Many collegiate and professional athletes from many sports have this surgery, but it’s most notable in baseball.

So why the sudden increase in the number of people having Tommy John surgery? Since 2004, the number of these surgeries has tripled in the major league pitching community, from 12 in 2004, to 36 in 2012. The surgery has proven to be so successful that pitchers want the surgery done as soon as possible, and the MLB boasts a long list of pitchers who have successfully returned to pitching afterward, earning tens of millions of dollars post-surgery. There is the lure of believing it’s a guaranteed fix, and for major league pitchers, a lot of money is at stake.

The downside: It’s not fool-proof

There’s no injury that can’t be made worse with surgery. A study in the American Journal of Sports Medicine showed a 97.2% rate of return to pitching in the pros. The rate of return is much lower in amateur or college athletes. The typical rehabilitation period is a year, but can be longer. Athletes can spend a long time on the disabled list and some might never see a return to full function. Pitchers are throwing higher velocity baseballs and something has to give when they keep this up over time. It seems it’s the elbow that takes the brunt of the force.

Younger and younger ages – A lesson for all kids

Kids these days seem to be forced into choosing a specific sport, which doesn’t allow any period of healing for parts of the body that are stressed. Well-meaning parents start a child in baseball at 5 or 6 as a pitcher, then a coach might encourage playing on a travel team in the off-season to continue improvement. As a result, studies show the child becomes three times more likely to end up requiring surgery than those kids who don’t play baseball year-round. Parents have to be careful about overuse in the body, paying attention to a child’s complaint about soreness and providing rest for that part of the body. More is not always better.

Myths

#1-The injury happened suddenly or from overuse in a game.

These are myths because tests have shown the ligament becomes torn and frayed over years. The years of abuse take their toll and the ligament snaps.

#2-Some pitchers have found that they throw harder after the Tommy John surgery.

Indeed, they might, but the results are not from the surgery. Pitchers throw harder as a result of the rigorous work they did for rehabilitation.

Question: How can you expect a ligament, that doesn’t have as much blood supply as the muscles, to endure repeated wear and tear from excessive, high velocity throwing, such as that which happens in pitching?

The answer: You can’t.

Pitchers have developed their musculature to deliver a pitch that maximizes their potential, but the ligaments and tendons simply can’t keep up with that force. We can’t expect that major league pitchers will slow down, but we can be aware of the demands we place on the Little Leaguers and other young athletes who compete or pitch in year-round travel teams where a lot of stress is placed on the elbow. We need to respond to their complaints of elbow pain with ice and rest.

The insights we’ve gained from the studies on Major League pitchers can be applied to many other people with elbow issues. Any elbow injury is initially treated with rest, nonsteroidal anti-inflammatories (ibuprofen), and ice. Patients then go through a physical therapy regimen to strengthen surrounding muscles. In some cases the injury will respond well to a cortisone or platelet injection. There are those candidates who prove to benefit from immediate surgery. These patients have not responded to non-surgical treatments and they want/need to resume strenuous throwing as soon as possible. In most cases these are elite high school, college or professional athletes who specialize in throwing. Orthopedic surgeons often recommend a non-surgical approach for weekend athletes as they will likely do just fine without “Tommy John” surgery.

The following articles were referenced for this newsletter:

http://www.usatoday.com/story/sports/mlb/2014/04/11/tommy-john-elbow-surgery-strasburg-parker-corbin/7583413/

http://en.wikipedia.org/wiki/Tommy_John_surgery

http://www.baseball-reference.com/bullpen/Tommy_John_surgery

http://www.webmd.com/fitness-exercise/tommy-john-surgery-ucl-reconstruction

Paragon Press – May 2014

Ortopedic News Bites


Could a Total Hip Replacement help me live longer?

Research has shown that patients who receive Total Hip Replacements (THR) have an improved quality of life and reduced overall pain. Some patients treat the hip pain without surgery, but studies show the replacement surgery:

  • Prolonged their lifespan
  • Reduced risk of heart failure
  • Reduced rate of depression
  • Lowered the risk of diabetes

Not only did these researchers prove there are added benefits to having a total hip replacement, patients actually save money by having the surgery. It is fairly expensive to manage disability related to hip arthritis.


Symptoms You Should NOT Ignore

Have you had something change in your health that made you scratch your head? Did it come out of the blue? Are you wondering if it’s worth a trip to the doctor’s office? Here are some of those issues you shouldn’t keep to yourself because they are indicators of a problem.

  • Constant canker sores: Can be a sign of celiac disease.
  • Blood in your stool: This can indicate many issues, such as colitis, diverticulitis, hemorrhoids, or even cancer.
  • Shortness of breath: Causes can range from asthma, to low blood pressure, to a heart attack.
  • Sudden weight loss/gain: Unexplained weight loss/gain of 5% of your body weight. Possible reasons: lack of sleep, stress, medication, or a new medical condition.
  • Sudden hearing loss: Sudden hearing loss is not related to a general wax build-up within the ear. Immediate treatment is very important to preserve hearing.
  • Confusion or personality changes: Changes in behavior or thinking can be from dehydration or low glucose levels, or from something more serious, such as reaction to a medication.
  • Flashes of light in your vision: These can result from migraines, or signal a retinal detachment. Immediate attention is needed for retinal detachments to prevent permanent vision loss.

Daily Aspirin Not Helpful For Everyone

An analysis of the data from major studies shows that only those who have had a previous heart attack or stroke will benefit from a daily low-dose tablet of aspirin. There is no evidence that taking aspirin as preventative medicine without a history of a heart attack, stroke, or heart problems is effective. In this case, a daily aspirin can actually put you at risk for its side effects, such as bleeding in the stomach or brain. Anyone considering taking low-dose aspirin needs to discuss the risks and benefits with their doctor to determine if it is helpful. If your doctor does recommend a daily aspirin, be sure to check the dose on the bottle and if there are added ingredients, as some aspirins combine other pain relievers that should not be taken for long-term therapy.

The following articles were referenced for this newsletter:

http://www.amjorthopedics.com/articles/conference-news/article/thr-may-reduce-mortality-heart-failure-and-have-other-benefits/509f00bf83be2c66f5d8396adcc26d3f.html

http://www.costcoconnection.com/connection/201312?pg=56#pg56

http://www.mayoclinic.org/symptoms/unexplained-weight-loss/basics/definition/sym-20050700

http://www.webmd.com/diet/features/5-surprising-reasons-you-are-gaining-weight

http://www.mayoclinic.org/healthy-living/adult-health/in-depth/symptoms-not-to-ignore/art-20045276?pg=1

http://www.rush.edu/rumc/page-1298330129309.html

http://www.webmd.com/heart-disease/news/20140506/daily-aspirin-regimen-not-safe-for-everyone-fda-warns

Paragon Press – April 2014

Stressed Out!

It’s all in your head…

Taxes overdue? Problems in your marriage? Not enough time in the day to get it all done? What are you doing about this stress? Some stress can be motivating, but when it becomes overwhelming, you need to take steps to lower it. Stress demonstrates its effects on our bodies in many ways: tense muscles that cause pain, heartburn, indigestion, decreased ability to fight infections and viruses, headaches, and disrupted sleep patterns, to name a few. There is a definite link between the physical and emotional states of our bodies. Studies on how stress compromises our immunity and wound healing demonstrate this. The good news is there are several things you can do to prevent or cope with stress, and stop it from getting the best of you.

Doctors in past generations used the “It’s all in your head” phrase a lot when it came to pain that was unexplained. Stress can exacerbate conditions you already have. Knowing that what happens in the brain affects the body can help us understand how we can reduce the effects of stress. When we have psychological stress, cortisol and other hormones make us ready to take action, otherwise known as the “Fight or Flight” mechanism. If the stress is from losing your job or impending surgery, the body’s reaction to “fight or flight” is not helpful. Neck muscles staying tense, the sleep disruptions, and a clenched jaw take a toll. This state of alarm can have a very negative effect on the body.

Being a patient is stressful!

Both before and after surgery, patients sometimes find themselves overwhelmed with stress.

How will I get around after surgery? I can’t afford the time off from work. What if the surgery doesn’t work?

Here are some things you can do to reduce the stress:

  • Get some exercise. You release endorphins when you exercise, which make you feel good. You also will use up the stress hormones your body has released when its under stress. Eliminate the negative emotional energy.
  • Go to bed at a decent hour and try not to take a nap longer than 30 minutes. You want to stay on a schedule of sleep, so your body has enough time to completely rest and recover.
  • Eat a balanced diet, including plenty of rehydrating fluids, fresh fruits and vegetables.
  • Do something with a friend. Social interaction and talking about what stresses you has been proven to relieve stress.

Other ideas

Some patients find that keeping a diary of how they are feeling helps them recognize patterns, such as headaches, or triggers. Try rating your pain level on a 1 to 10 scale several times a day. Progressive muscle relaxation, developed by physician Edmund Jacobsen in the 1920’s, is a technique where you consciously tense and relax groups of muscles. A link at the end of this newsletter explains this technique in further detail. You might find that putting your stress into words is helpful by itself. Keeping a journal of what stresses you helps you organize your thoughts and can put the stressors into focus, triggering a sense of control.

What about Marijuana?

While some advocate for its use to relieve stress, a recent study at Northwestern University has found that even a little recreational use causes changes in the brain. These researchers discovered abnormalities in two vital brain regions responsible for motivation and emotions. Don’t fool yourself into thinking that smoking pot will not have harmful consequences. The data from this research directly contradicts the common notion that a little bit of pot is harmless.

“Worry never robs tomorrow of its sorrow, it only saps today of its joy.” – Leo Buscaglia

The following articles were referenced for this newsletter:

http://online.wsj.com/news/articles/SB123724722718848829?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB123724722718848829.html

http://guides.wsj.com/health/wellness-and-diet/how-to-manage-stress/

http://www.virginia.edu/uvaprint/HSC/pdf/14010.pdf

http://en.wikipedia.org/wiki/Progressive_muscle_relaxation

http://www.washingtonpost.com/news/morning-mix/wp/2014/04/16/even-casually-smoking-marijuana-can-change-your-brain-study-says/?tid=pm_national_pop

http://www.health.harvard.edu/special_health_reports/stress_control

Paragon Press – February 2014

What is PRP?

There is a new therapy that is utilized to relieve pain from tendon injuries or osteoarthritis. This amazing new option does not require surgery and takes under an hour to complete. It is called Platelet-Rich Plasma, or PRP as it is known. Paragon Orthopedic Center has been performing these injections for over 4 years and has seen great success in pain relief. We have injected over 400 patients with PRP, ranging from high school and college athletes to patients in their 70’s. If you or someone you know endures chronic tendonitis, slow healing injuries or certain forms of osteoarthritis, this might be a great solution. Another benefit of this therapy is that it allows the body to begin healing more quickly. Want to know more? Continue reading to further understand this innovative technique.

How Is It Done?

PRP injections are performed in one of our examination rooms, using the ultrasound machine to guide the injection into the damaged tendon or joint space. First, the patient’s blood is drawn by our trained technicians. This blood is placed in a special centrifuge and the platelets are separated from the other blood components, taking about 15 minutes. Only platelets are needed because they are what aid in the healing process by binding together when they recognize injury within the body. This is called platelet-rich plasma (PRP). With the aid of an ultrasound machine, this PRP is injected back into the damaged tissue.

Then What?

Patients must rest that area for 2 weeks in order to allow the platelets to work in that injection area. The platelets release special growth factors that stimulate the regeneration of the blood vessels and new tissue during this time. After this rest period, physical therapy is suggested for 6 weeks. Dr. Bents likes to see his patients at 2 and 6 weeks after the injection for evaluation. Certain patients require more than one injection before they see improvement. The majority of patients find that they are able to return to their pre-injury activities with excellent pain relief.

Am I a Candidate?

The most common condition that responds well to PRP is rotator cuff tendonitis. We have also had excellent success with lateral elbow pain (tennis elbow) and Achilles tendonitis. Patients who have moderate arthritis in the knee, hip, or shoulder may be candidates as well. There have been studies showing up to 12 months of relief from PRP injections in knees with arthritis. This therapy is considered after other therapies have failed, such as anti-inflammatory medications, rest, and physical therapy.

What do I do if I want to give PRP a try?

Dr. Bents can perform injections in the office with an appointment. Call our office today to schedule an evaluation: 541-472-0604, Monday through Friday, 8am to 5pm.

The following articles were referenced for this newsletter:

https://www.emoryhealthcare.org/sports-medicine/procedures/advanced-techniques/prp-therapy.html

http://www.hopkinsmedicine.org/heart_vascular_institute/clinical_services/centers_excellence/womens_cardiovascular_health_center/patient_information/health_topics/platelets.html

Paragon Press – January 2014

Happy New Year From Paragon Orthopedics!

NEWS FLASH-Let’s get that brain thinking and see how well you paid attention last year. Here is a 2013 review quiz of health and food news. See what you can remember.

1-In January, several European food companies were found to be fraudulently labeling what kind of meat as beef?
A) Horse, B) Llama, C) Squirrel, D) Pigeon

2-What ‘80’s throwback was the hottest health food of this year?
A) Pop Rocks, B) Spam, C) Crystal Pepsi, D) Chia Seeds

3-What was behind this year’s biggest food scare?
A) Corn, B) Cantaloupe, C) Bagged Salad, D) Eggs

4-This caused the major problems during the rollout of the Affordable Care Act:
A) Glitches in the Web Site, B) A Nurse’s Strike, C) Changing the name of Food Stamps to SNAP, D) Required Dental Coverage

5-The FDA took a step toward banning this:
A) 32-oz sodas, B) Trans Fats, C) High Fructose Corn Syrup, D) Cute characters that promote unhealthy food aimed at children

6-The FDA in November said that trans fats are no longer recognized safe. Companies have been moving away from trans fats for years. Which product still contains trans fats?
A) Sara Lee Cheesecakes, B) McDonald’s French Fries, C) Oreo Cookies,
D) Kellogg’s Pop Tarts

7-Federal regulators began scrutinizing:
A) E-Cigarettes, B) Medical Marijuana, C) Genetically Modified Foods, D) Moonshine

8-An outbreak of what caused a scare on two college campuses?
A) MRSA, B) Mononucleosis, C) Meningitis, D) Shingles

9-Which was not a new diet plan this year?
A) Paleo, B) Whole 30, C) Bullet Proof Diet, D) Ornish diet.

10-Which of these products was revived this year?
A) Apple Newtons, B) Planter’s Cheese Balls, C) Crystal Pepsi, D) Twinkies

11-US farmers in the heart of tobacco country are trying to grow which crop as demand for hummus explodes?
A) Corn, B) Chickpeas, C) Peppers, D) Lettuce

12-What percent of the world eats goat meat? Nearly:
A) 20%, B) 40%, C) 50%, or D) 70%

13– Which is NOT a new law to Oregon in 2014?
A) A law prohibits mothers from taking home their placentas at any time after giving birth. B) The minimum wage goes up $0.15, C) It is illegal to smoke in a car with kids, D) The maximum fine for texting while driving goes up from $250 to $500.

************************************************************************************************************

ANSWERS:

1-A Horse,
2-D Chia seeds. Chia seeds have gained attention as a good source of omega-3 fatty acid and fiber.
3-C Salad Mix. More than 600 people in 25 states and New York City became sick after eating food infected with a parasite called cyclospora. Public health officials in Iowa and Nebraska traced the infection to a salad mix.
4-A Glitches in the web site
. Also called Obamacare, the Affordable Care Act was rolled out at the end of 2013 and problems with the web site prevented many Americans from enrolling. Although the site was working better by December, glitches remained.
5-B Trans Fats
Also known as partially hydrogenated oils, the FDA should be making their final ruling on the ban on these oils in early 2014. If banned, the oils would be phased out over several years in foods such as frozen pizzas, microwave popcorn, premade doughs, and many store-bought baked goods.
6-A Sara Lee Cheesecakes.
7-A E-cigarettes These cigarettes have not been approved by the FDA for the use of turning chemicals into a vapor that is inhaled by the user. The FDA wants to regulate them like other nicotine products and say they may have toxic ingredients.
8-C Meningitis Most students recovered without problems, but one University of California student had both feet amputated. Symptoms include: fever with a rash, bad headaches, and neck stiffness.
9-B The Whole 30 All are diet fads, but the Whole30 Diet is new to 2013. It is basically an extremist “caveman” plan. While the strict plants and meat diet will surely spur weight loss by eliminating refined sugars, the diet is far from sustainable and is not designed to be that way. It sets up a yo-yo pattern of weight loss and weight gain.
10-D Twinkies All are products of the ‘80’s, but Twinkies returned to store shelves in July under new ownership after Hostess filed for bankruptcy.
11-B Chickpeas. This is the main ingredient in hummus.
12-D Nearly 70% of all red meat consumed globally is goat meat.
13-A A law prohibits mothers from taking home their placentas at any time after giving birth. A tricky question. This is exactly the opposite of the new 2014 law; mothers CAN take home their placentas after birth. All of the others are new laws for 2014.

These were tough questions, and even if you only got one or two correct, you hopefully had a little fun learning something.

The following articles were referenced for this newsletter:
http://www.usatoday.com/story/news/nation/2013/03/05/gluten-free-diet-popularity/1963715/
http://www.chicagotribune.com/features/holiday/sns-year-in-review-2013-news-quiz-gallery,0,6753943.photogallery
http://www.webmd.com/a-to-z-guides/rm-quiz-year-in-review-2013
Wall Street Journal, Thursday, December 26, 2014, p.B1
http://www.statesmanjournal.com/article/20131229/NEWS/312290027/Oregon-rings-new-14-laws
http://oregoncoastdailynews.wordpress.com/2013/12/31/new-dmv-drivers-test-rules-for-teen-drivers/
http://www.webmd.com/food-recipes/understanding-trans-fats?page=2

Paragon Press – December 2013

How many of these bone-depleting factors apply to you?

Stress & anxiety Sedentary lifestyle Nutrient deficiency Too much animal protein Hormonal imbalance High caffeine use Poor eating habits
Smoking Processed food Early menopause Some prescriptions Inadequate vegetable & fruit intake Lack of sleep Sugar
Ovary removal Hysterectomy Low sun exposure Inflammation Digestive weakness Dieting Underweight
Corticosteroids Excessive Cola drinks High salt intake High fat diet Alcohol/drug use Poor vitamin D intake Heavy metal exposure

All of these can deplete the strength of your bones, and it’s time you took an honest look at changes you can make. As you look at how many apply to you, consider that every one you eliminate is better for your bones. You could take on one or two as your 2014 New Year’s resolutions. It might mean not having a broken hip in the future, or a wrist fracture when you take a spill. Broken bones usually cause missed work days and major changes to daily living, so why not do all you can to prevent a break. Park farther away from the store’s doors, and take a healthy lunch to work, instead of picking up fast food. Drink milk instead of iced tea with dinner. Substitute a handful of almonds instead of that candy bar. Read up on how hormonal changes increase your need for calcium and talk to your doctor about this. Get control over your vices, whether they are alcohol, coffee, sugary snacks, or salty meals. To increase your chances of sticking with the changes you choose, make the healthier choices gradually and a part of your daily life, so that these choices become habits. Don’t quit coffee altogether, but cut down on your daily intake. Hopefully, you’ll never know the fracture you could have had.

When you make diet changes remember the foods that are HIGH IN CALCIUM.
Cheese • Orange Juice fortified with Calcium • Dark, Leafy Greens • Tofu • Soybeans • Milk
Cereals fortified with Calcium • Yogurt • Enriched breads

Do you have healthy feet? While you might eat a healthy diet, exercise routinely, and educate yourself on a healthy lifestyle, this question might be tough to answer. High heels, worn out workout shoes, and shoes with little support can lead to stress on the feet that affects other parts of the body. Did you ever consider that those $5 flipflops offer no support, possibly leading to muscle strain and lower back pain? High heels can shift your weight so that you are stressing your hips and back. You might be wondering why your back has been so sore when the answer has been on your feet.

A current health trend is for “minimalist shoes,” and while some studies show they have benefits, you do not want to jump into a pair and hit the road for marathon training. If you are used to wearing a bulky shoe, the shoe is doing the work and your body will not be ready to take on that load immediately. A minimalist shoe allows the foot, ankle, and lower leg to do the support work and stability when your body is in motion.

***MERRY CHRISTMAS***
FROM EVERYONE AT PARAGON ORTHOPEDICS
IN GRANTS PASS, O­­REGON

Paragon Press – November 2013

Happy Thanksgiving from Paragon Orthopedics!

Which Is Healthier?

The holidays are upon us and many of those celebrations revolve around food in one way or another. Are you hoping make healthier choices from the buffet table? Here is a short quiz to see if you can spot which choice is better for you.

Cow’s Milk vs. Soy Milk

Winner: Cow’s milk because it has more calcium and protein than soy milk. Also, sugar is added to soy milk to help it taste better. Unless you are lactose intolerant, 1% or skim milk is a better choice.

Jam vs. Jelly

Winner: Jam because it is made with actual fruit. Jelly is made with fruit juice and sugar. Jams also have added sugar, but at least there is a little vitamin C in it.

Steel-cut oats vs. rolled oats

Winner: It’s a tie. Both have nearly identical nutritional value. Don’t believe there is less nutrition to rolled oats because they are not raw, like steel-cut.

Greek Yogurt vs. Regular Yogurt

Winner: Greek yogurt because it is higher in protein, has about half of the carbohydrates as regular, and less sugar per ounce. Watch what you stir into that Greek yogurt! Regular yogurt is the winner for calcium content, so if your main concern is calcium, stick with regular.

Multigrain vs. Whole Grain products

Winner: Whole grain. A product that is multigrain has more than one type of grain, but not necessarily whole grains. You might see “Seven Grains” and this is an example of multigrain. You want whole grains because they contain all parts of the grain kernel, making them more nutritious. Whole grains are good sources of B vitamins and fiber.

Iceberg vs. Romaine Lettuce

Winner: Romaine. It has huge doses of vitamins A and K. Red Leaf lettuce comes in a close second, but Iceberg is 96% water and has the least nutrition out of all the choices of greens in a salad bar. Spinach also packs a nutritional punch with loads of vitamin A and K, as well.

Turkey burgers vs. hamburgers

It’s a tie. Turkey burgers are lower in calories, fat (especially saturated), and higher in calcium, but hamburgers have more protein and potassium. Surprisingly, hamburgers are lower in cholesterol when compared to 85% lean turkey burgers.

The following articles were referenced for this newsletter:
http://www.mayoclinic.com/health/multigrain/AN02047
http://www.fitsugar.com/Nutritional-Difference-Between-Hamburgers-Turkey-Burgers-11319750
http://lifehacker.com/5921760/use-this-chart-to-pick-the-most-nutritious-leafy-greens

Paragon Press – October 2013

The PATIENT PORTAL is Here!

Paragon Orthopedic Center is introducing the Paragon Patient Portal to make your orthopedic care easier to manage. This easy online service gives you access to your medical records, Paragon forms and paperwork, and prescription refills, all from your home computer. Getting yourself set up is a simple process that is clearly and easily laid out for you in one of our brochures. This Portal is a secure site, so you can be reassured that your patient information is safe and remains absolutely private.

With the Patient Portal you can:

  • Request appointments
  • Request prescription refills
  • Send secure messages to the office staff
  • Request your health record
  • Receive test results
  • Do paperwork for your appointment
  • Pay your bill online
  • Get appointment reminders and notifications via text!

Paragon has brochures available in the clinic to help you get started on the Portal and we are always available to answer questions. Manage your care at your convenience, in the comfort of your home, saving time, gas, and paper. Stop by today and discover how easy your orthopedic care at Paragon Orthopedics can be.

Did you know laughter can boost your immunity? It decreases your levels of stress hormones and increases immune cells and infection-fighting antibodies. Your body releases endorphins when you laugh, which can promote an overall sense of well-being. Watch a few I Love Lucy episodes and laugh yourself healthy!

The following articles were referenced for this newsletter: http://www.helpguide.org/life/humor_laughter_health.htm

Paragon Press – July 2013

Treating Scars

Look in the “skin care” aisle of your local store and you will find several offerings for scar treatment. Many of us have scars from mishaps or surgeries and when they appear in noticeable places, we want them to be gone. For most people, it’s difficult to know which remedies might be quack cures and which produce real results. Here is some information to help you understand scarring better and available treatments.

WHY DOES SKIN SCAR?
Scars are the result of abnormal formation of collagen in the skin after an injury.

WHAT IS THE BEST WAY TO AVOID A SCAR?
Keeping the wound moist is key. Letting the wound form a scab will cause a worse-looking scar. Using plain old Vaseline under a BandAid is an easy and inexpensive way to keep it moist. If you are looking to use moisturizers, know that the more ingredients they have, the higher the chance of an allergic reaction. Also, keep the wound covered. Exposure to sun will worsen any discoloration of the wounded area and cause the tissue to thicken. Scars are very sensitive, so they brown quickly. This discoloration and tissue thickening make any sort of treatment more difficult. If the area is on your face, liberally apply sunscreen with an SPF of at least 50.

DO DRUGSTORE REMEDIES WORK?
Most drugstore remedies do not have any effect on scars. Vitamin E is an ingredient in some scar-healing products. It’s known for properties that lessen inflammation, but it hasn’t been proven to do much for scars. When it works, it is likely the result of the moisturizing effect that simply keeps the skin hydrated. Some people develop allergic reactions or skin irritations to Vitamin E, thus making healing more difficult.
Onion extract is another ingredient found in drug store creams, but is not scientifically proven to help.
One over-the-counter product known to help is silicone. It is often found as an adhesive sheet that sticks to the scar. Some experts think this works on scars because of the pressure that is applied to the skin through the bandage. It’s a slow process when you use this product and can be very expensive, with estimates at $40/month. Silicone can require up to two full years of use for full healing, requiring patience and diligence.

ARE ANY HOME REMEDIES USEFUL?
None is a guaranteed cure. Stay away from folksy home remedies, such as rubbing lemons or onions on the scar. These can be irritating and kill the healthy cells. Honey is one home remedy that might be useful. It promotes healing, yet kills off other bacteria and fungi. This shouldn’t be considered superior to keeping the wound moist, however.

MASSAGE THERAPY
You can try massaging the scar: 1-after stitches have been removed, 2-after the scab has fallen off, and 3-there is no risk of reopening the wound. Scar massage can prevent scar tissue buildup, puckering of the skin at its edges, and help range of motion. For lubrication, use a quality lotion without added scent, like Nivea or Eucerin. Additives can cause skin irritation. Ask for guidance from your healthcare provider. Note that massage will not help old scars.

ARE MEDICAL PROCEDURES WORTH THE COST?
Laser therapy has been shown to help thick or red scars. Cortisone injections are used to flatten thick or raised scars. A certified Dermatologist can determine if either of these would be helpful. These can be expensive, sometimes up to $500 a treatment, and require more than one procedure for optimal results. With some scars, you might be replacing one scar with another that looks better if it cannot be eliminated, which can happen in with acne damage.
If you try any scar treatment and the area shows signs of infection, such as pain, redness, bleeding, tenderness, or drainage, consult your healthcare professional immediately.

HAPPY INDEPENDENCE DAY
TO ALL OUR PATIENTS AND A BIG THANK YOU TO ALL WHO HAVE SERVED OR ARE SERVING OUR COUNTRY!
WE ARE PROUD OF YOU!

The following articles were referenced for this newsletter:
http://articles.latimes.com/2011/apr/17/health/la-he-scars-20110417