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Texas Orthopedics, Sports & Rehabilitation Associates

Monday, November 20, 2017

RA and Sleep

With shorter days, longer nights, and the hint of a chill now finally in the air, conditions are ripe for some sweet slumbering.  Sadly though, that may not be in the cards if you are one of the 75% of people with rheumatoid arthritis (RA) who report sleep problems.
RA is an autoimmune deficiency causing painful inflammation of the joints and surrounding tissues. Stiff joints can keep you awake at night and make it difficult to find a comfortable sleeping position.
One big way to alleviate sleeplessness at night is to exercise during the day. Physical activity can help lubricate joints so that they are not as stiff and tight. And, exercise actually tires you out so that you are more relaxed and restful by the end of the day.  (Avoid working out within three hours of your bedtime because the adrenalin boost that you get can keep you awake.)
Check with your rheumatologist or physical therapist about which type of exercise is best for you and your condition. Good options for those suffering from RA include low-impact activities like walking, swimming, yoga, tai chi, and Pilates.
Here are some other tips to help get some Z’s:
  • Stick to a sleep schedule, and go to bed and wake up every day at close to the same hour.
  • Limit caffeine and alcohol consumption, especially later in the day. 
  • Wind down before hitting the hay. Read, take a warm bath (which can also soothe joint pain), or enjoy a cup of herbal tea.
  • Outfit your bedroom for optimal sleep—cover windows, limit electronics displaying disruptive bright lights or noise, and adjust thermostats so you’ll be comfortable all night, especially as the temperature drops.
If you still have serious sleep issues and are not getting at least six to eight hours per night, due to your RA symptoms, please contact us for an appointment with one of our rheumatologists.
(Adapted from Healthgrades)

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Opiod Alternaties and Dr. Goldberg on KVUE

The Trump administration recently declared the opioid epidemic a public health emergency and is taking action to address it.

But physicians are also doing their part to help alleviate the risk of addiction among their surgical patients by recommending over-the-counter pain relief remedies first.

One recent study published in the JAMA (Journal of the American Medical Association) pitted opioids against a combination of acetaminophen (Tylenol) and ibuprofen (Advil) to alleviate pain during common ER visits for sprains, strains, fractures, and other minor injuries.

Of the more than 400 men and women evaluated, there were no significant differences reported in either pain relief or how fast relief took place when using a combination of acetaminophen and ibuprofen OR corresponding doses of oxycodone, hydrocodone, or codeine.

Texas Orthopedics’ own Dr. Tyler Goldberg is practicing this same protocol on most of his surgery patients and he discussed it with ABC affiliate KVUE-TV.

Dr. Goldberg has stopped prescribing opioids after surgery in about 85 percent of his patients. He explained that some patient can become addicted, or physically dependent, on these drugs in as little as seven days.

For an alternative pain protocol, he recommends patients try Tylenol first, along with cold/ice therapy, anti-inflammatory medications to reduce swelling, and movement of the limb or joint as soon as possible to get blood flowing and avoid stiffness.

Orthopedic surgeons everywhere, like Dr. Goldberg, have been instrumental in educating patients about other options to manage pain. Check out the AAOS’ stance on prescription safety here.

You can view the full story featuring Dr. Goldberg and one of his surgery patients here.

Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Monday, November 13, 2017

Movember and Men's Health

At Texas Orthopedics, we focus on orthopedic and sports-related issues affecting men and women. But in November, we hear a lot about 'Movember' and men's medical conditions like prostate and testicular cancer, depression and suicide prevention.

And we see a lot more facial hair in the process because some men mark this month by growing outlandish mustaches to show their support or by raising funds through locally organized walks, runs, and other events.

According to the American Cancer Society, prostate cancer is the second most common form of cancer striking men today, following skin cancer. Here are a few things you should know about it:
  • It's prevalent in older men over the age of 50.
  • About one in seven men will be diagnosed with it in their lifetime.
  • It is highly treatable if discovered early.
Like prostate cancer, testicular cancer responds very well to treatment if caught early. It is found more in younger and middler-aged men with the average age of diagnosis being 33.

Visit the American Cancer Society for the risk factors and symptoms of each.

Along with cancer, other health issues men face that could have serious consequences--even prove fatal--if not treated properly include heart disease, diabetes, kidney disease, and COPD which affects the lungs.

Men, listen up--to ensure that you are at your very best:
  • Schedule regular exams, and have a conversation with your physician about a PSA test (for prostate cancer) and other important screenings suited to your health history.
  • Know your body: every inch, wrinkle, crease, fold, bump, bulge, and bruise. Get checked out immediately if something ever feels or looks abnormal or has difficulty healing.
  • Move more. Stay fit and active, maintain a healthy body weight, and eat well.
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic)

(Courtesy of the Movember Foundation)

Hot or cold? Which is best for muscle recovery?

If you're participating in an upcoming holiday fun run, or training for a more series half or full marathon in the next few months, it's important to plan how you'll help your muscles recover after training and after the race.

Some runners prefer heat and warmth to soothe their tired limbs, while others prefer an icy numbness. There is a longstanding medical debate as to which is better for sore muscles--hot or cold treatment.

A new study appearing in the Journal of Physiology shows that heat may be edging out ice.

Researchers at the Karolinska Institutet (Sweden) subjected a group of men and women to a series of arm exercises (via an arm pedaling machine) at an intense pace, with shorter bouts of easier movements woven in. They tracked both heart rate and muscle power output.

After the routine, the men and women slipped on long warmed arm cuffs (heated to 100°F) and then later chilled cuffs registering at around 5°F. They were also given carbohydrates to refuel. Here are the key findings:
  • Participants were more eager to return to the rigorous arm activity after their muscles had been warmed.
  • Muscle power output was "markedly better" following the warm cuffs, and pain reported was minimal.
  • Muscle output decreased after the cooling cuffs.

While the study does suggest that heat can play an important role in muscle recovery, researchers were also quick to add that consumption of carbohydrates (specifically the glycogen found in carbs) after intense exercise is crucial.

It may be that the nourishment found in carbs is more easily activated when the body is warmed up as opposed to chilled...leading to muscles feeling better, faster.

The study states that the most beneficial treatment though is really what feels best and is most comforting to you, whether hot or cold. That along with a hearty helping of carbs and hydration, will have your muscles rebounding in no time.

If you have intense muscle pain or cramping that does not subside a few days following training, a race, or extreme exercise, please contact us for an appointment.

Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Friday, November 10, 2017

Veterans Day 2017

Veterans Day is celebrated on November 11 of each year to commemorate the end of World War I.

Texas Orthopedics is honored to salute all of the active duty and retired servicemen and women who we have treated over the years. We humbly thank them for their selfless dedication to our country.

We are also honored to have with us in our Texas Orthopedics family several staff members who have serviced in the armed forces as well, including:

  • Dr. Peter Garcia
  • Dr. Richard Lutz
  • Dr. Bradley Adams
  • Dr. Zachariah Logan
  • Jody Ramirez
  • Jo Lopez
  • Debbie Jara
  • Allen Schultz
  • Jessica Bradley
  • Kathy Mitchell
  • Megan White
  • Anthony Papp
  • Adrian Garcia 
  • Brian Dearing
Please join us in acknowledging these men and women, and all of those who have so bravely served in the military.

Happy Veterans Day!

Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Monday, November 6, 2017

Fishing Injuries

Those who love fishing often go all out for the sport...hook, line, and sinker. With access to so many lakes and rivers in Central Texas, and the Gulf Coast just a few hours away, it's no wonder this is a fisherman's paradise. What's not paradise is suffering an injury while enjoying a day on the water.

Most fishing injuries involve the hand and wrist, including:
  • Fish bites and impalements: resulting in soft-tissue or tendon damage
  • Sting ray lacerations (if fishing in salt water): when the sting ray's venomous barb pierces the skin
  • Lodged fish bones or scales: also piercing the skin in a splinter-like fashion and possibly trapping harmful bacteria underneath
  • Hand and wrist overuse injuries: as in sports like baseball and golf, repetitive use of the wrist in casting and reeling motions can cause damage to the joint and surrounding tendons.
Another serious condition to be aware of is Fish Handler's Disease. This happens when you have an existing cut or scrape and you handle a diseased fish, which could cause a serious bacterial infection. Symptoms can include fever, swelling, tenderness, and bruised-like spots at the site of the wound. Antibiotics are often the only way to treat it.

With any fishing injury resulting in significant blood loss, be sure to:
  • Clean the wound with warm, soapy water
  • Bandage it with clean dressings
  • Get medical attention immediately if you think you need stitches
If you've been injured while fishing and suffer from an existing health condition like diabetes of an autoimmune disorder such as arthritis, seek treatment from a certified hand specialist. It is also a good idea to wear protective gloves.

As a reminder, always remember to carry a First Aid kit with you when fishing, and note the quickest route back to land (if boating) in case of a medical emergency.

Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Monday, October 30, 2017

Halloween Safety

As you head out for tricks and treats with your little goblins, be aware of some potentially scary stuff on Halloween night. And we don’t mean the black cats and haunted houses…
The National Safety Council claims Halloween night is one of the most dangerous of the year—warning that kids are more than twice as likely to be hit (and killed!) by a car on Halloween more so than any other day.
In addition to pedestrian/automobile accidents, Halloween creates the perfect storm for many other common injuries. Being out at dark (even dusk) and running around excitedly from house to house can lead to trips, falls and:
Here are some tips to help your little ones stay safe while trick-or-treating:
  • Make sure costumes don’t restrict movement or vision and aren’t too long or dragging on the ground
  • Map out your route beforehand and stay on streets that are well-lit
  • Bring along flashlights, glow-sticks and even reflective gear to make your presence known
  • Stay on sidewalks or defined paths and watch vigilantly for cars while crossing streets
  • Never allow kids to eat already opened or unpackaged treats
  • Teach kids to never enter a person’s home when ringing the doorbell, no matter how friendly they are
 For older children and teens:
  • Educate them about the dangerous consequences of getting in the car with someone who has been drinking on this night – or any night
  • Establish a firm time for them to be home
  • Alert them to the hazards of walking in the dark while talking or texting at the same time--a seemingly innocent and common occurrence that could potentially lead to a serious accident
Have a safe and happy Halloween from Texas Orthopedics!
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).
(Courtesy of the National Safety Council)

Friday, October 27, 2017

Dr. Tyler Goldberg in Honduras

Dr. Tyler Goldberg and twenty-one other healthcare professionals recently traveled to Honduras with One World Surgery on a humanitarian trip. While there, they faced a logistical nightmare as they dealt with the effects of one of the most devastating hurricanes in U.S. history—Hurricane Harvey.

Not wanting to disappoint the many patients awaiting joint replacement surgery at the Holy Family Surgery Center there, the group changed course and rerouted their original travel through Miami instead of storm-ravaged Houston to arrive in the tiny Central American country.

It took a great deal of coordination and perseverance to get there, Dr. Goldberg told a reporter from Becker’s ASC Review.   

“Coordination is key when performing a short-term mission trip,” said Dr. Goldberg. “No one person can do this alone."

Due to the impending arrival of yet another hurricane (this time Irma) and once again fraught travel scenarios, the team had just three days to complete 20 surgeries before having to return home.

In all, 15 total knee replacements were performed as well as five total hip replacements--a phenomenal feat given the short amount of time.

Dr. Goldberg commented that the patients in Honduras were so grateful for their generous medical assistance that it was an absolute pleasure to care for them despite the challenging circumstances.

You can read the entire article about Dr. Goldberg and his team right here.  

Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Monday, October 23, 2017

Muscle Aches and Pains

Austin is the live music capital of the world, with a regular stream of headliners in town. Just this month, we’ve seen great groups come through for ACL and more recently performing at the Circuit of the Americas’ Formula One racing events.
Much like athletes, musicians’ bodies suffer a great deal of wear and tear from their profession.
Musculoskeletal disorders plague 73.4% to 87.7% of all musicians, with string players reporting the highest prevalence.
Tickling the ivories, strumming a guitar, or playing drums repetitively through a grueling rehearsal schedule and back-to-back performances can do a number on fingers, wrists, the neck, and shoulders. And then there’s the added stress of hauling heavy instruments and equipment from one gig to the next.
Bones and joints can become easily fatigued from this repetitive use, leading to pain, inflammation, and potentially serious conditions like arthritis.  Arthritis occurs when the cartilage between joints breaks down resulting in weakened bones, and decreased flexibility and range of motion.
Other common issues facing musicians include:

Whether you’re a pro or amateur musician, here are a few ways to ensure that your body stays healthy from fingertips to tops of shoulders:
Warm up before playing with light finger, wrist and arm stretches as well as head, neck and shoulder rolls to loosen muscles
Like in sports or intense athletic training, build in rest time every few days to allow muscles and bones time to rest and recuperate
Never play through pain or with an injury
If you suffer from chronic aches and pains as a result of playing an instrument, please contact us for an appointment with one of our specialists.  
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Breast Cancer and Women's Health Issues

While breast cancer is the most commonly diagnosed form of cancer among women, it is second in deaths behind lung cancer according to the American Cancer Society.
Every two minutes in the United States, a woman is diagnosed with breast cancer, and every 13 minutes, a woman dies from it.
The good news is that there are more than 3.3 million breast cancer survivors alive today in America due to enormous advancements in both preventative screenings and treatment.
Alongside cancer, the other leading health issues facing women today include heart disease, stroke, diabetes, lower respiratory diseases, and Alzheimer’s.
Many factors contributing to these diseases can be chalked up to genetics. Beyond genetics though, medical experts agree that prevention is key.
Encourage the special women in your life to be their best by:
  • Eating a well-balanced diet
  • Maintaining a healthy weight and exercising daily
  • Not smoking
  • Wearing sunscreen regularly
  • Drinking alcoholic beverages in moderation
Staying on top of regular medical exams, screenings like mammograms, and immunizations
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

Monday, October 16, 2017

Knocked Out Teeth

We've been sharing lots of reminders on how to keep your body safe during this fall sports season, but let's not forget about your pearly whites.
The American Association of Endodontists reports that more than 5 million teeth are damaged each year while playing sports. This number refers to teeth that have been fully knocked out, loosened or cracked.
Wearing a mouth-guard is the best way to protect your teeth while playing sports. Even if it’s not a full-contact sport like football or hockey, player collisions can be disastrous for an unprotected mouth.
Make sure the guard is brand new, and molded to fit your mouth exclusively. And look for products with the ADA Seal (American Dental Association).
In the event of a traumatic tooth injury, take these steps to minimize damage and help save the tooth:
  • If a tooth has completely been knocked out, pick it up by the crown (top) not the root at the bottom to help protect the nerve there.
  • Rinse the tooth in clean water if possible to remove any dirt or blood, and place it somewhere safe until you get medical assistance.
  • Safe spots for lost teeth include:
    • Back inside the mouth, gently stored between the gums and the cheek.
    • In a clean container filled with saliva, milk, or saline solution where the enzymes will help preserve it. Avoid submerging it in regular tap water as it can dry out the tooth and delicate root tissue
    • Wrapped in a moist cloth, napkin, or paper towel.
Seek medical attention within 30 minutes of a lost tooth for the best chance of saving it. Teeth that have been knocked out can often be replanted, or splinted back into place if done quickly.
If it’s a primary, or baby tooth, the situation isn’t as dire because a permanent one will eventually grow in.
Additionally, if you suspect any broken bones (such as in the jaw or neck) accompanying a knocked-out tooth, or concussion-like symptoms, get help immediately.
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).
(Adapted from STOP Sports Injuries)

Arthritis and the Flu Shot

Sadly, thousands of people die each year from complications due to the common flu.
At the greatest risk are young children, pregnant women, seniors, and those with autoimmune conditions like rheumatoid arthritis.
People with arthritis—a debilitating weakening of bones and joints—often take medication to help manage pain, reduce swelling and inflammation, and improve flexibility. These types of medications can suppress the immune system, leaving a patient susceptible to infection and other illness.
The CDC (Centers for Disease Control and Prevention) recommends all those who fall into this greater risk category get the flu vaccine before flu season starts and that means…now! Getting vaccinated can help prevent you from getting the flu, and reduce the potential for doctor’s visits, hospital stays, and missed work.
The CDC also suggests that if you have a weakened immune system, encourage those who you’re in close contact with to get the vaccine, too.
The flu vaccine is available in shot or (nasal) spray/mist form. The injected version of the vaccine is often thought to be more effective because the mist has a live, weakened form of the virus. This can have side effects for those with already suppressed immune systems. Talk to your doctor about which one is right for you.
Symptoms of the flu to watch out for include:
  • Fever and chills
  • Muscle aches
  • Vomiting
  • Headaches
  • Cough, congestion, or runny nose
Besides getting vaccinated, other ways to avoid the flu include frequent handwashing, limited contact with those who have it, and following a healthy diet of vitamin-rich foods.
If you are suffering from arthritis, and have questions or concerns about the upcoming flu season, please contact us for an appointment with one of our specialists.
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).

(Adapted from the Arthritis Foundation)

Monday, October 9, 2017

Reminder About Fall Sports Safety

Goals have been scored. Touchdown passes thrown. And just like that, the fall sports season is halfway done.
Whether a player on the field, runner on a cross-country course, or cheerleader atop a human pyramid, every fall athlete is at risk for a sports injury.
According to the CDC (Centers for Disease Control and Prevention), more than 2.6 million kids (up to 19 years of age) are treated in the ER annually for sports and recreation-related injuries.  
We treat a good number of young student athletes here at Texas Orthopedics every day.
Here’s what we’re currently seeing:
There’s also an uptick of sports-related concussions reported during the fall.
In order to be able to play safely through to the winter season, here are some reminders for staying injury-free:
Continue to check all equipment (helmets, shoes, shin guards, mouth guards, etc.) regularly for damage and proper fit.
Keep in constant communication with coaches and trainers and let them know if you are in pain, sick or struggling and need a brief break from games or practices.
Stay fueled up with a healthy diet and tons of water to hydrate as the fall is still typically very warm in Central Texas.
Follow all instructions from your physician or orthopedist for rest and recovery if you’ve already suffered an injury this season.
Please contact us if your child needs to be seen for a sports injury, or if it’s after-hours (as most sports injuries tend to be), visit our Urgent Injury Clinic where no appointment is necessary.
Keep up with Texas Orthopedics news by following us on Facebook and Twitter (@TexasOrthopedic).
(Courtesy of STOP Sports Injuries)