FAQ Category: General

You may be suffering from a condition called post-traumatic stress disorder (PTSD). This is a mental illness that can occur after any major trauma. The person may have seen or experienced a death, violent act, or intense event causing great fear or helplessness.

PTSD was first seen in military soldiers after combat. According to a study from the Denver Health Medical Center, outside the military, PTSD is most common after a motor vehicle accident. Other causes include falls, gunshot wounds, and motorcycle or bicycle accidents.

A qualified doctor must diagnose this problem. It’s viewed like any other medical problem. Medications and counseling are the two most common and successful ways to treat PTSD.

Not necessarily. Some traumatic events can just be more than even a stable mind can handle. Humans have limits!

Mental health professionals trained in these types of problems call this post-traumatic stress disorder (PTSD). The affected person sees or experiences an event that causes major distress. They become impaired in social, work, or emotional functioning. They may have bad dreams about the event.

Patients with PTSD can become irritable, angry, and unable to sleep. They may start to avoid people or activities.

PTSD is fairly common after orthopedic trauma. In fact a recent study reported PTSD in over half of all patients seen in a Denver trauma center. The events leading to the PTSD included motor-vehicle accidents, falls, and motorcycle or bicycle accidents.

You may want to suggest your sister seek some help if her distress has lasted longer than one month. Early recognition and treatment of this problem is the key to recovery.

There are two forms of arthritis: rheumatoid and osteoarthritis (OA). OA is the most common type in the United States. It affects one in three adults. In 2002 70 million people were diagosed with OA.

Arthritis is second only to heart disease as a cause of work disability. It limits daily activities such as walking, dressing and bathing for more than 7 million Americans.

Baby boomers (adults born between 1946 and 1964) are now at risk. Many people with arthritis don’t think anything can be done to help them. Drugs such as you see advertised on television, exercise, and physical therapy are the first treatment options used. If these fail, injections or surgery can help.

For more information, visit the website of the Arthritis Foundation at http://www.arthritis.org.

Your doctor is the best one to advise you on this. There is a hormone called relaxin that helps joints and soft tissues around the joints relax or loosen up.

Some studies have looked at the amount of knee joint laxity (looseness) during pregnancy. Relaxin levels go up in the first three months and then decrease after that. Knee laxity increases in all three trimesters of pregnancy.

There are concerns about joint injuries because of hormonal changes. Other changes in pregnancy added to this one suggest caution is needed when joining in team sports.

Sports hernia (also known as athletic pubalgia) has the same name as a true hernia. In reality the two are not alike. A true abdominal, inguinal, or femoral hernia is an abnormal opening in the abdominal wall. Part of the intestine pushes through. The danger is that the bowel can get strangled and form gangrene. This condition can be life-threatening.

A sports hernia is a torn tendon, fascia, or ligament in the abdominal and/or groin area. It isn’t life-threatening but it can cause chronic groin pain. Athletes involved in high speed twisting and turning are affected most often. The athlete with a sports hernia won’t be able to play in his or her sport until the damage is repaired.

The most common cause of persistent groin pain in athletes is a sports hernia. The sudden twisting and turning at high speeds is a contributing factor. A weakness in the abdominal fascia separates from a tendon that is shared by two muscles in the area.

Other possible causes of chronic groin pain must be ruled out. Appendicitis is possible but unlikely. Nerve entrapment and stress fractures of the pelvis or spine are also possible. Tendonitis at the point of tendon insertion into the bone is another cause of groin pain.

Dr. William Meyers from Philadelphia is a sports hernia specialist. He is the chairman of the department of Surgery at the Drexel School of Medicine. Dr. Meyers is a well-known liver surgeon who also studied new ways to treat athletic groin pain. Many professional
athletes have been treated by Dr. Meyers for this problem.

Sports hernia is also known as athletic pubalgia. It’s most common among athletes involved in sports that require twisting and turning at high speed. Soccer, ice hockey, and tennis players are at greatest risk. It’s an injury that’s been reported just
in the last five or six years.

Groin pain on one or both sides is the first symptom. Often the doctor can’t find anything with tests or an exam. The exact pathology isn’t fully understood and may vary from patient to patient. The structure involved is the inguinal canal. The spermatic cord
in men and the round ligament in women are inside this passage. The canal itself is formed by various structures in the abdominal area.

Doctors repairing this injury report tendon, oblique, or fascial tears as the main feature of this injury. The fascia gets torn loose from the internal oblique tendon or inguinal ligament. The athlete keeps playing and putting shearing force across the area. More layers of tissue separate from the inguinal ligament resulting in persistent groin pain.

Surgery is usually needed to repair the damage before the pain goes away.

The factors most commonly linked with OA are age, female, obesity, trauma, and loose joints. Postmenopausal women who are overweight and smoke may be at greatest risk.

Some studies show life expectancy decreases when the person has OA. OA in the finger joints is especially likely to predict a decrease in the number of years a person lives. The reason for this is unknown.

Genetics and heredity may also play a key role in OA. More study is needed to find the exact gene or genetic link between OA and death. Until then we can’t say for sure your aunts’ age at death was directly linked to their OA.

In some cases, yes. Exercise training to increase muscle strength and endurance still uses this basic formula. Usually the person looks for a weight that allows him or her to do 10 repetitions without stopping and with good form.

Each exercise is done at the same speed and slowly enough to give muscle fibers time to contract. The amount of weight and number of repetitions can be increased over time. Increase the weight and reps as much as you can while still using proper form and without soreness afterwards.

Other exercise programs are being developed specific to each sport, injury, or disease. Many studies are underway to find exercises that work best for each one of these. The standard three sets of 10 reps may not be best when exercise is used to prevent or treat diseases. For example, heart disease or cancer must be treated with exercise using a very different approach.

You may be talking about minimally invasive operations. This means a smaller incision or opening is made during the surgery. There are many examples of this kind of procedure. There’s the arthroscopic meniscectomy. The surgoen takes out damaged knee
cartilage through a slender device inserted into the joint.

The arthroscope can also be used to repair many other problems from rotator cuff tears in the shoulder to lower leg bone fractures. Another device called the endoscope
allows the doctor to do a carpal tunnel release under the skin without making a big incision.

The appendix or gallbladder can be removed using a laparoscope. This tool allows the doctor to make small holes to enter and exit the abdomen. Spine surgery can also be
done using the mini approach. Surgeons remove disc material or fuse the vertebrae without using a big incision to open the back.

These are only a few examples of the new ways to do surgery with the smallest incision possible. As tools and technology get better we will probably see more of these minimally
invasive procedures.

Ovarian cancer has often been called a silent killer. Yet more than 90 percent of women have symptoms long before the disease is identified. However, these symptoms are often
vague or misleading. Stomach upset, joint pain, finger swelling are just a few examples.

There isn’t a reliable screening test for this kind of cancer yet. CA 27.29 and CA 125 are often increased when a woman has ovarian cancer but not always. CA stands for “cancer antigen.” By the time a mass is felt or seen, the cancer has often spread to other organs or outside the abdomen.

In your mother’s case, the doctors may not have looked for ovarian cancer right away because she was an older woman. The peak age for ovarian cancer is around 56 years.

There isn’t a simple answer known to mankind on this one. If there were, it would be worth a fortune! Besides training, many athletes use a wide variety of nutritional approaches with diet and supplements. Perhaps there is a magic recipe of factors that make THE difference.

From research on the subject of athletic performance, we know that balance and reaction time are important. These can be adversely affected by stretching long and hard just before an event. It’s important to stay warmed up but too much stretching can actually reduce performance.

Even a small loss of dynamic balance and tiny change in reaction time can make a difference in the personal times of the top sprinters of the world.

When and how to stretch continues to be the center of research and debate. Some say a long, slow static (holding steady) stretch is best. Others suggest using a more relaxed approach by stretching through movement such as Tai Chi.

Many people practice the theory “no pain, no gain” by holding a stretch as long as possible at the point of pain and discomfort. It’s likely that a more moderate approach works best. A recent Canadian study showed that acute stretching (45 seconds to the point of discomfort, repeated three times) actually reduces balance and skill right after stretching.

Riding a stationary bicycle for five minutes before activity gave better results all around. Most people (athletes included) don’t have the time to stretch every muscle. But the increased body heat and blood supply from the bike activity can improve balance and reaction time.

Specific gentle but prolonged stretching can be done at the end of the activity. Try to relax into the stretch when exhaling or breathing out.

Stretching is often touted as the answer to increasing motion around the joints and improving athletic performance. Studies show it does increase motion but it may not improve performance. In fact, it may even make performance worse!

Stretching after a muscle strain is important in order to restore muscle length as it heals. Otherwise you may end up with tendon-muscle stiffness and tightness. This could put you back at risk for another muscle injury.

The answers are not all in yet, but it looks like a gentle warm-up before activity is best. Stretching can be done after exercise. This will achieve the desired result without decreasing current performance.

“Off-label” refers to the use of drugs and medical devices for some other purpose than what they were meant to be used for. For example, a drug for seizures (Neurontin) has been found to work for patients with diabetes who have nerve pain from peripheral neuropathies. Another off label use is a drug for asthma (Terbutaline). This drug is used to prevent premature labor in pregnant women. Or there’s the spine surgeon who uses substitute bone graft in ways that haven’t been tested yet.

The Food and Drug Administration (FDA) requires doctors to use legal drugs and devices as they were meant to be used. Doctors are free to prescribe as they wish but the FDA says drug-makers can’t advertise treatments that aren’t tested or approved.

Off label use must be done with careful record keeping. It’s considered “investigational” until studied and proven effective. It can have dangerous side effects including death.

Osteoarthritis (OA) is more common in women than men by a two to one (2:1) ratio. Women are more likely to have arthritis in both knees. And, as you suspect, women who are overweight are more likely to have OA.

Some scientists think the link between obesity and OA is so strong. They say, “obesity causes knee OA.” Others feel obesity is a risk factor for OA. In other words, your chances of developing OA are greater if you are overweight.

Obesity is a risk factor for loss of mobility and function in patients with OA. In this sense, obesity is a risk factor for disability as well. Patients having knee surgery are more likely to be overweight. And they are more likely to have less function and more
limitations after the operation. This is compared to women the same age having the same surgery who are normal-weight.

Men can be affected by osteoporosis, but the ratio is four to one. That means four women have osteoporosis for every one man with this condition. When men are affected, they are usually much older (over 75 years old). Since many men don’t live this long, there are
fewer cases of osteoporosis in men.

There are several other reasons why women have osteoporosis more often than men. Boys have more skeletal mass build up during growth compared to girls. As a result, men have more bone size per square inch. The change in estrogen levels after menopause has a
direct effect on women. Men may have some hormonal changes. These are much less and slower in men compared to women.

There are other risk factors that affect men and women equally. These include smoking, alcohol abuse, and poor diet. Inactivity and too little sunshine (a source of vitamin D) can increase anyone’s chances of developing osteoporosis.

Joint and muscle stiffness is a natural part of aging. It can also be an early symptom of other medical conditions like osteoarthritis, lupus, or thyroid problems to name a few. It might be a good idea to have a physical check up, especially if you haven’t done this in a while.

If your stiffness is normal then a few simple guidelines may help. First stay hydrated. Drink plenty of water, clear liquids, or clear, fruit juices. Stay active. Regular exercise as simple as walking or biking done three or four times each week has been shown to help.

Consider trying a stretching class, yoga, Tai Chi, or other form of slow, rhythmic movement. It may take several months, but this type of exercise often helps maintain motion and may even restore motion lost over the last months and years.

Get to bed early enough at night to get up 15 to 20 minutes earlier in the morning. Try to do some gentle movements of the head, neck, shoulders, and hands while in the shower. After getting dressed, take an extra five minutes to do a little stretching, yoga, or Tai Chi.

Aging is linked with osteoarthritis (OA) of the joints. The hip and knee are affected most often.

Stiffness is also common as we get older. There are many reasons for this. Tendons and ligaments have less water in them. The drying effect makes the joints seem stiff. The cells that make up soft tissues are called collagen. Fewer new collagen cells are formed so we lose some elasticity in the joints and muscles.

There are other changes going on in the joints. The cartilage loses strength. Changes in the cells of the cartilage lead to OA. There is a thinning of the joint space as the cartilage breaks down. This loss in joint space can be seen on X-ray. It’s the most common way to diagnose OA.

A medical doctor will use tests of motion and strength along with X-rays to make the diagnosis. An early diagnosis is best so that early treatment can limit problems.

Doctors and nurses are paying more attention to prevention in medicine. Blood pressure problems are a common cause of falls in older adults. Your mother’s nurse may be screening her for any changes in blood pressure that can put her at increased risk for
falls.

Your mother may not have high blood pressure. When it comes to falls and hip fractures, low blood pressure can be just as dangerous as high blood pressure in the older adult. Going from a seated position to standing can cause a sudden drop in blood pressure. The patient may get dizzy and lose his or her balance.

Once the nurse identifies any risk factors for falls then a program of prevention can be started. Whenever you go with your mother for her checkups, ask questions. Find out as much as you can about her health needs. You may be able to help her make some changes at
home in her diet and activities that can keep her healthier longer.