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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.

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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.
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(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.


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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!

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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).