Dr. Justin Roberts joining TOCA September 3, 2018

Dr. Roberts, MD is excited to be joining the outstanding physicians at The Orthopedic Clinic Association.

Dr. Justin Roberts is an orthopaedic surgeon who is fellowship trained in surgery of the foot and ankle. He specializes in comprehensive care of both simple and complex foot and ankle conditions including sports injuries, fractures, arthritis, and deformity. He has special interests in ankle replacement, flat foot correction, bunion correction, arthroscopy, traumatic and post-traumatic reconstruction.

Dr. Roberts was born and raised in Bakersfield, California. He received his undergraduate degree at the University of California, Santa Barbara, then attended medical school at the University of California, San Diego. Dr. Roberts came to Phoenix for orthopaedic residency at Banner University Medical Center, then completed fellowship training at the Orthopaedics Associates of Michigan in Grand Rapids, MI. During fellowship, he received comprehensive training in complex surgical reconstruction of the foot and ankle.

Dr. Roberts promotes a relaxed atmosphere where open and honest communication is encouraged. Patient education is a critical part of his practice, and he will take the time to explain your condition and all treatment options. He emphasizes exhausting non-operative measures prior to recommending surgical intervention. Dr. Roberts understands that foot and ankle problems can be very disabling and recovery can be extensive. He is dedicated to working with you through every step to get you back to the quality of life you desire.

When not working, Dr. Roberts enjoys rugby, fishing, golf and spending time with his family.

 

Dr. Padley has a long tradition of providing care for sports teams.

Dr. Padley returned to the Dominican Republic in April with the Cincinnati Reds for the annual opening of their Dominican complex. The trip included evaluations of 40+ Dominican athletes hoping to advance their way up the Cincinnati Reds baseball system. This marks the beginning of the baseball season for the Dominican teams. Most major league baseball teams have affiliates in the Dominican in search of that next great player! Dr. Padley is an orthopedic consultant and provider to the Cincinnati Reds for major league baseball spring training and throughout the year for their minor league and rookie league teams. In additional to this health care relationship, he is also a consultant to Japanese professional baseball for the Saitama Seibu Lions. With his expertise in hip disorders and injuries, Ballet Arizona benefits from his service as a consultant. He was a team physician for the WNBA’s Phoenix Mercury for four years including the 2014 championship season. Dr. Padley proudly serves as the team physician for Benedictine University in Mesa as well as Millennium and Verrado High Schools in Goodyear.

For more information on Dr. Padley, Click HERE

 

Congratulations to Dr. Evan Lederman, Top Doc!

[vc_row][vc_column][vc_column_text]Congratulations to TOCA Physician and Orthopedic Surgeon Dr. Evan Lederman, who was named as a Top Orthopedic Surgeon 2017 in the Phoenix Magazine Top Doc’s 2018 publication.

The TOCA Physicians and Orthopedic Surgeons have been ranked in Phoenix Magazine’s Top Docs consecutively since 2004!

Dr. Lederman is board certified in orthopedic surgery and subspecialty board certified in orthopedic sports medicine. Dr. Lederman has been practicing in Phoenix, Arizona since 1996. He has years of experience with specialty training in sports medicine, minimally invasive arthroscopic surgery of the shoulder and knee and complex reconstructive surgery. His practice encourages non-operative care when possible and considers surgery only when necessary. Dr. Lederman specializes in all disorders of the shoulder including advanced techniques for rotator cuff repair, shoulder instability repair, acromioclavicular joint repair and primary and revision shoulder replacement including reversed shoulder replacement and also specializes in knee arthroscopy and ACL reconstruction.

Dr. Lederman’s work has earned him acceptance as an associate member of the American Shoulder and Elbow Surgeons (ASES) and is only the second surgeon in Arizona to receive this prestigious honor. He has been awarded the distinction of Phoenix Magazine’s Top Doc and Phoenix SuperDoctors. He has been named one of the “20 of the Top North American Shoulder Surgeons: 2015″ by Orthopedics This Week.

To schedule an appointment with one of TOCA’s physicians call 602-277-6211 today!

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Join Team TOCA with Dr. Feng & the Arthritis Foundation for the Walk to Cure Arthritis!

Enjoy the beautiful Arizona weather by joining Team TOCA, Dr. Earl Feng (Orthopedic Surgeon, Arthritis & Total Joint Reconstruction) and the Arthritis Foundation in the Annual Walk for the Cure, Saturday May 5th, 2018 at the Phoenix Zoo! Dr. Feng is not only a TOCA Physician & Surgeon but also serves as a Board Member for the Arthritis Foundation!

At TOCA, each of us has an important role in helping the more than 1.2 million Arizonans living with arthritis including many our patients, our colleagues, and more than 6,000 children in Arizona alone. TOCA is proud to continue our support the 2018 Arizona Walk to Cure Arthritis on May 5th at the Phoenix Zoo. As a sponsor of the Walk to Cure Arthritis, our goal is to help more people with arthritis.

The Arthritis Foundation is the Champion of Yes for patients with arthritis who are being told “no” a lot. No, there isn’t a cure. No, you cannot play sports. No, you cannot pick-up your grandchild.

Here is how you can help!

• Through funding critical research for osteoarthritis to find better treatments and ultimately a cure.
• Giving kids living with arthritis the opportunity to attend Camp Cruz to meet other kids living with arthritis.
• Supporting programs like the Live Yes network for people in our community struggling with pain, connecting them with others with arthritis.
• Getting a patient get back on their feet so they can walk their dog.
• Helping a grandparent alleviate back pain so they can pick up their grandchild.
• Saying “YES” to a patient today!

The event features a three-mile and one-mile course, with arthritis information and activities for the entire family!

Let’s raise funds to find a cure for arthritis, then come together to support each other and walk! Every step counts, every dollar matters!  The Arthritis Foundation’s Walk to Cure Arthritis to help the more than 50 million Americans and 300,000 children with arthritis live better today and to keep the Arthritis Foundation’s promise of finding a cure for tomorrow. Be a Champion of Yes – join our team and raise funds to fight arthritis and find a cure, all while having A LOT OF FUN! If you aren’t able to join the team, we’d appreciate your donation to help reach our goal.

Click here to learn more about this event, join Team TOCA and/or Donate Today! Team TOCA

Event Location:
The Phoenix Zoo
455 N Galvin Pkwy
Phoenix , AZ 85008
Event Schedule:
Event Registration Starts 5/5/2017 6:30 am
Event Registration Ends 5/5/2017 8:00 am
Event Starts 5/5/2017 7:30 am
Event Ends 5/5/2017 10:00 am
Fees:
Walk to Cure Arthritis Registration: No Fees
Event Registration

To Learn more about Dr. Feng and TOCA visit: www.tocamd.com or call 602-277-6211

#Arthritisfoundation #WalktoCureArthritis #Results #Recovery #Relife#TOCAMD #TOCA #ArthritisPhxWalk #PhoenixZoo

Breast Cancer Patients & The Benefits of Physical Therapy

#NationalBreastCancerAwarenessMonth, #NationalMammographyDay #NationalPhysicalTherapyMonth

Breast Cancer Physical Therapy TOCA TOCAMD TOCA Physical Therapy Cancer RecoveryOctober is Breast Cancer Awareness Month, an annual campaign to raise awareness of breast cancer risks, the value of screening and early detection, and treatment options available to women and men who are diagnosed with one of the many forms of breast cancer. More than 249,000 people in the United States are diagnosed with invasive breast cancer every year, and nearly 41,000 die from the disease.

Over the years, a loop of pink ribbon has come to symbolize breast cancer awareness

Breast Cancer is one of the most common forms of cancer affecting women today. Approximately one in eight women will develop breast cancer in their lifetime. Research and treatments continue to make advancements, and today, there are many treatments available to eliminate breast cancer. However, there are many different side effects to every treatment provided. Common side effects for Cancer, and the treatments for it, can cause physical problems such as pain, numbness, swelling, weakness, fatigue, stiffness, loss of balance, and difficulty moving or walking. Physical therapists help people manage cancer-related problems, improve their health and functional abilities, and return to work and other activities.

Physical Activity and the Cancer Patient

In the past, people being treated for a chronic illness (an illness a person may live with for a long time, like cancer or diabetes) were often told by their doctor to rest and reduce their physical activity. This is good advice if movement causes pain, rapid heart rate, or shortness of breath. But newer research has shown that exercise is not only safe and possible during cancer treatment, but it can improve how well you function physically and your quality of life.

Too much rest can lead to loss of body function, muscle weakness, and reduced range of motion. So today, many cancer care teams are urging their patients to be as physically active as possible during cancer treatment. Many people are learning about the advantages of being physically active after treatment, too.

How Can a Physical Therapist Help?

Physical Therapy, PT, TOCA PT, TOCA Physical Therapy, Cancer Treatment, Cancer pain management, Physical Therapy and CancerPhysical therapists are trained and educated to understand all of your health conditions, including a cancer diagnosis. Your physical therapist will work with you to develop a specialized treatment program to address your specific needs and goals.

The American Cancer Society recommends people undergoing cancer treatment, and cancer survivors, perform consistent physical exercise to decrease fatigue, and improve the ability to perform normal daily activities. Studies show that exercise can improve an individual’s chances of surviving cancer. Physical therapists can design individualized exercise and treatment programs to reduce or prevent many cancer-related problems.

Physical therapy can decrease these common side effects and improve the quality of life during and after cancer treatment. A physical therapist will design an individualized treatment program including specific strengthening exercises, endurance training, and stretching. Physical therapists also offer a variety of manual therapy techniques to reduce scar tissue adhesions; pains associated with scars and surgery, and improve flexibility.

Physical therapists help people diagnosed with cancer before and after surgery. Before surgery, they evaluate individuals for any of the problems listed above, and help address them. After surgery, they can help with the healing of the incision site, improve circulation, reduce pain, and minimize scarring. They evaluate individuals for any physical therapy treatment needs, and, by designing individualized treatment programs, help them recover and heal faster than they would on their own.

Research has shown that physical activity and exercise have beneficial effects on health after breast cancer treatment and during treatment. It is a safe and feasible option to improve strength, range of motion, maintain muscle, and improve cardiovascular fitness. Physical activity can even be beneficial during chemotherapy or radiation therapy; however, low intensity exercise should be performed. “While currently, it is unclear if exercise improves chemotherapy results, there is no evidence of a negative effect of exercise on response to chemotherapy.”1

Physical activity has also been shown to improve fatigue, anxiety, self-esteem, depression, cardiovascular fitness, muscle strength, and body composition. Research has also shown that individuals receiving cancer treatment who participate in an exercise program have a reduced risk of disease recurrence and improved survival rate, as well as decreased risk of osteoporosis, diabetes, and cardiovascular disease.

Your physical therapist may work with you to improve your:

Comfort and well-being. Cancer and cancer treatments can cause symptoms such as pain, burning sensations, numbness, tingling (neuropathy), cramps, spasms, and weakness. Your physical therapist may apply hands-on techniques (manual therapy) or technologies like electrical stimulation to help decrease your pain and alleviate your symptoms. The physical therapist may teach you gentle exercises or techniques to perform at home to aid your recovery. All of these options may reduce or eliminate the need for opioid pain medication.

Aerobic capacity. Cancer or cancer treatment may have decreased your ability to process oxygen (aerobic capacity), causing fatigue. Research shows that aerobic exercise, such as walking on a treadmill for at least 20 minutes 3 times per week, may help improve aerobic capacity, reduce fatigue, and optimize healing. Your physical therapist can assess your aerobic capacity and determine the best aerobic activities for you.

Bone density. Lack of activity and certain cancer treatments can cause weakening of your bones, which could lead to bone fractures. Certain types of exercise can prevent bone loss and maintain bone strength. Your physical therapist can teach you safe and effective exercises to help steadily build your bone strength.

Lymphedema and swelling. Certain cancer treatments can result in lymphedema (swelling in the arms or legs) or other types of swelling. Your physical therapist can use several methods to reduce, control, and prevent lymphedema and swelling, such as specialized gentle massage, special movements and exercises, and application of compressive garments such as arm sleeves, gloves, and leg stockings.

Surgical incisions. Your physical therapist can help you care for any surgical incisions and sutured areas, by checking for infection and assisting with dressing changes. The physical therapist also can help prevent some kinds of scarring and skin tightness as the suture line heals. Your physical therapist can use very gentle massage or certain technologies to keep the skin as soft and pliable as possible.

Body weight. By creating an exercise and physical activity program tailored just for you, your physical therapist will help you reduce body fat and maintain a healthy body weight, which can improve your energy levels.

Mood. Exercise helps elevate mood and reduce depression in everyone, including cancer patients and survivors. A diagnosis of cancer, and cancer treatment, can be stressful and cause mood changes in anyone. Proper exercise, individualized for each person by a physical therapist, can help reduce stress and improve mood.

Brain fog. Exercise helps relieve brain fog. Your physical therapist can design an individualized program of exercise that can help reduce memory loss and brain fog.

Daily activities. Your physical therapist will discuss activity goals with you and use them to design your treatment program. Cancer survivors usually increase their physical activity gradually; your treatment program will help you reach your goals in the safest, fastest, and most effective way possible.

Walking. Your physical therapist will help improve your ability to walk using techniques such as strengthening exercises, walking training, and balance activities. If you have nerve damage (neuropathy), your physical therapist may provide bracing and other techniques to make it easier or safer for you to walk. Your physical therapist also may recommend using an assistive device, such as a walker or cane.

Sports training ability. Athletes undergoing cancer treatment can continue to train for their sport to a degree, depending on the type of cancer and treatment. Physical therapists design safe, challenging, sport-specific training programs to help athletes reduce loss of fitness and strength during cancer treatment.

Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in any stiff joints. These might begin with “passive” motions that the physical therapist performs for you, and progress to active exercises and stretches that you do yourself. You can perform these motions at home to help hasten healing and pain relief.

Flexibility. Your physical therapist will determine if any muscles are tight, start helping you to stretch them, and teach you how to stretch them at home.

Strength. If your physical therapist finds any weak or injured muscles, the physical therapist will choose, and teach you, the correct exercises to steadily restore your strength and agility.

Coordination. Your physical therapist will help you improve and regain your coordination and agility, so you can perform household, community, and sports activities with greater ease.

Balance. Your physical therapist will examine your balance, and choose specific exercises that you can perform in the clinic and at home to improve your balance and prevent falls. Your physical therapist may also teach you how to use a cane or walker to help maintain your balance when walking and standing.

Home program. Your physical therapist will teach you strengthening, stretching, and pain reduction exercises to perform at home. These exercises will be designed specifically for your needs.

Some exercises that you can perform include:

  • Yoga to improve flexibility
  • Deep breathing exercises to improve relaxation and provide psychological benefits
  • Aerobic exercise like walking, jogging, and swimming to assist with weight management and improve cardiovascular fitness
  • Resistance training to improve muscle mass.

You should always consult your doctor to determine any precautions or limitations to exercising. It is important to note that all therapeutic exercise programs should be tailored to each individual and their specific needs. If you experience any increase of weakness, loss of balance, increase of pain, unusual swelling or swelling increases, headaches, dizziness, blurred vision, or new numbness/tingling you should stop your exercises and contact your doctor.

Precautions for cancer survivors who want to exercise

During and shortly after cancer treatment

Always check with your doctor before starting any exercise program. This is especially important if your treatments can affect your lungs (such as the chemo drug bleomycin or radiation to the chest), your heart (such as the chemo drugs doxorubicin or epirubicin), or if you are at risk for lung or heart disease. Be sure you understand what you can and can’t do.

 

If you, or someone you know, are currently undergoing or have recently received Breast Cancer treatment and wish to set up an exercise program, please contact the dedicated team at TOCA by calling 602-277-6211 today!

Read more on TOCA Physical Therapy Here  and our Friday Facts on Physical Therapy Article Here

If you have any further questions you can look through the resources in this paper or go to the American Cancer Society web page.

For tools and calculators (In this section you’ll find interactive tools, quizzes, and videos to help you learn more about ways to lower your risk for cancer or find it early) visit: https://www.cancer.org/healthy/tools-and-calculators.html

For more information on ‘Tests to Find and Diagnose Cancer’ (Screening increases the chances of detecting certain cancers early, when they are most likely to be curable. Learn about the types of tests done to find and diagnose cancer here.) visit: https://www.cancer.org/healthy/find-cancer-early/tests-to-find-and-diagnose-cancer.html

 

#NationalBreastCancerAwarenessMonth, #NationalMammographyDay #NationalPhysicalTherapyMonth #MyOrthoDoc #TOCA #TOCAMD #PhysicalTherpy #Orthopedics #BreastCancer #BCA #BreastCancerAwareness #BreastCancerFighter #Cancer #FightLikeAGirl #MaleBreastCancer #Pinktober #RethinkPink #WhatGivesMeStrenth #EveryActionCounts #healthandwellness #Recovery #Results #Relief #movement #wellness #rehab #motivation #medicine #surgery #elbow #shoulder #arthroplasty

Further Reading

The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions, and also prepare them for a visit with their health care provider.

The following articles provide some of the best scientific evidence related to physical therapy treatment of cancer problems. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.

Mohamady HM, Elsisi HF, Aneis YM. Impact of moderate intensity aerobic exercise on chemotherapy-induced anemia in elderly women with breast cancer: a randomized controlled clinical trial. J Adv Res. 2017;8(1):7-12. Free Article.

Cornette T, Vincent F, Mandigout S, et al. Effects of home-based exercise training on VO2 in breast cancer patients under adjuvant or neoadjuvant chemotherapy (SAPA): a randomized controlled trial. Eur J Phys Rehabil Med. 2016;52(2):223–232. Free Article.

Van Waart H, Stuiver MM, van Harten AW, et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015;33(17):1918–1927. Free Article.

Al-Majid S, Wilson LD, Rakovski C, Coburn JW. Effects of exercise on biobehavioral outcomes of fatigue during cancer treatment: results of a feasibility study. Biol Res Nurs. 2015;17(1):40–48. Free Article.

Yang TY, Chen ML, Li CC. Effects of an aerobic exercise programme on fatigue for patients with breast cancer undergoing radiotherapy. J Clin Nurs. 2015;24(1-2):202–211. Article Summary in PubMed.

Bergenthal N, Will A, Streckmann F, et al. Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev. 2014;(11):CD009075. Free Article.

Hornsby WE, Douglas PS, West MJ, et al. Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: a phase II randomized trial. Acta Oncol. 2014;53(1):65–74. Free Article.

Murtezani A, Ibraimi Z, Bakalli A, Krasnigi S, Disha ED, Kurtishi I. The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial. J Cancer Res Ther. 2014;10(3):658–664. Free Article.

Mishra SI, Scherer RW, Snyder C, Geigle PM, Bertanstein DR, Topaloglu O. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. 2012;(8):CD008465. Article Summary in PubMed.

Brdareski Z, Djurovic A, Susnjar S, et al. Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: a pilot study. Vojnosanit Pregl. 2012;69(3):237–242. Article Summary in PubMed.

Jones LW, Douglas PS, Eves ND, et al. Rationale and design of the Exercise Intensity Trial (EXCITE): a randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer. BMC Cancer. 2010;10:531. Free Article.

Kampshoff CS, Buffart LM, Schep G, van Mechelen W, Brug J, Chinapaw MJ. Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue. BMC Cancer; 2010;10:658. Free Article.

Schwartz AL, Winters-Stone K, Gallucci B. Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum. 2007;34(3):627–633. Article Summary in PubMed.

Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007;25(13):1713–1721. Free Article.

*PubMed is a free online resource developed by the National Center for Biotechnology Information (NCBI). PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database.

Authored by Andrea Avruskin, PT, DPTReviewed by the MoveForwardPT.com editorial board.

 

Halloween Safety Tips from your OrthoDocs

Halloween is known as a favorite holiday, full of spooky fun and lots of candy. However, it can also present many opportunities for injury, as we take to the streets in pursuit of trick-or-treating goodies. Let’s talk Halloween Safety!

Monsters and aliens are not the only scary things out on October 31st. Trips and falls (or even more serious accidents) can put a damper on Halloween festivities. But a little preparation and thought can go a long way in protecting you and your children from harm.Pedestrian injuries are the most common type of Halloween injury. There are four to five times more pedestrian fatalities on Halloween versus the average for the rest of the year.

Other common Halloween injuries are trips and falls from costumes that are too big or obstruct sight; burns from highly-flammable costumes; and cuts while carving pumpkins.

The following tips taken from the American Academy of Pediatrics and physicians at TOCA offers the following tips for Halloween safety:

Halloween Safety Tips from your OrthoDocs!

REMEMBER: The main thing to do is use your own common sense and rust your parental instincts. If it doesn’t feel safe or comfortable, then it probably isn’t; go with your gut, follow our advice, and keep things safe this Halloween.

Choosing a Costume

Everyone loves dressing up at Halloween, children most of all. And it’s so sweet seeing them go from door-to-door trick or treating locally – who doesn’t take a million pictures before they go out with their little buckets? But sadly it can be dangerous for some children, as there have been a number of well-documented accidents where children’s Halloween costumes were set alight by accident.

Don’t worry too much though- there are lots of things you can do to mitigate the risk. You need to make sure what you buy is as safe as it can be from candles, fires and sparks, and you need to brief them on what to look out for, as well as what to do if the worst happens. We’re sure everyone will stay safe this Halloween, but you can be super sure if you read our fullproof guide to Halloween costume safety!

1. Use flame-resistant materials

As it’s Halloween, your child is very likely to be near candles, lanterns, and other decorative flames. Polyester and nylon are both flame-resistant materials, for example. When picking out your child’s costume always look for the label “flame-resistant” and make sure there is a visible CE mark.

REMEMBER: It’s safer to choose costumes made up of one layer of heavier materials as opposed to flimsy, layered, frilly ones. Thinner materials made up of lots of layers tend to burn much faster because more oxygen can get to the fire.

2. Pick a costume that’s made out of ONE material

Costumes that are made of one single type of material will often catch fire more slowly than those that are made out of lots of different materials.

If a costume is made of a variety of different fabrics, they can all react to a flame in a different way and, in some cases, can fuel the fire even faster.

3. Wear clothes UNDER the costume

Not only because it can go from warm to chilly here in Arizona when you’re trick or treating but also because it’s safer. Speaking about costumes, Kevin O’Neill from the Fire and Rescue Service said: “These are toys. Toys have a lower fire safety requirement. They have a lower fire safety standard. Just be aware of that and take measures.

One of those measures is to ensure children are wearing clothes under the costume.

They should be wearing woollen tights for example or a woollen jumper or jeans. That way it gives some protection that if they were to catch fire you’ve still got a barrier between the garment and your skin.”

4. Ditch the capes

Capes are very common on Halloween costumes, but – as proven by Madonna – they can pose a tripping hazard even to adults. More worryingly, however, is the fact that they pose a strangulation risk.

And on that note…

Avoid costumes and costume jewellery that is tight around the throat. Avoid anything, especially cords and sashes, that tie around the neck.

5. Read the label on face paints

If you are buying face paints then they should be FDA approved. Always look for a CE mark and always check the packaging displays clear ingredients in English.

And remember that the words ‘non-toxic’ doesn’t always mean it will be safe for your skin. Do an allergy test on a small patch of skin before using on you or your childs face.

No matter how tired you are following a night of fun, make sure you remove any costume makeup before bedroom to prevent possible skin irritation.

6. Keep an eye on accessories and props

Swords, knives, and other costume accessories should be short, soft, and flexible. If you think if you, a friend or your child would be hurt if their was a fall on the accessory, be it a wand or a sword, then do not wear it.

Again, look for a visible CE mark when purchasing.

7. Be careful with masks

You want to make sure that a mask fits well (so that it’s comfortable and doesn’t slip), that the eye holes are big enough to see out of, and that you can breathe comfortably while wearing it.

8. Remember to stay visible

Choose bright and light coloured costumes and clothing wherever possible. If you or your kids are heading out trick-or-treating or an outdoor party, carry a glow stick, and buy reflective tape and attach it to your/ your childs costume. This will ensure that motorists can see your child – and that you can keep an eye on them!

9. Don’t forget the shoes!

Related imageWear well-fitting, sturdy shoes. You don’t need to wear “red-carpet starlet” high heels; leave them at home and pop on sturdy footwear that you won’t trip in.

And, on the note, remember that many shoes that come with costumes are NOT meant for outdoor use; make sure your child is wearing shoes that fit properly and have proper grip to them, so that they don’t slip and fall. Also so they can comfortably survive the night walking around in their shoes.

10. And of course, make sure it fits

Do not purchase costumes that are flimsy, billowing, too big, or that drag on the ground; not only will this be a tripping hazard, but it could also get caught up in Halloween candles.

A Few Additional Halloween Safety Precautions:

While Out Trick or Treating

  • Be safe, be seen. To easily see and be seen, children should also carry flashlights.
  • Young children should always be accompanied by an adult or an older, responsible child.
  • All children should WALK, not run, from house to house and use the sidewalk, if available, rather than walk in the street.
  • Cross streets at the corner, use crosswalks (where they exist), and do not cross between parked cars.
  • Parents should plan out the trick-or-treating route – best to stay on well lit roads with sidewalks.
  • Children should be cautioned against running out from between parked cars or across lawns and yards where ornaments, furniture, or clotheslines present dangers.
  • For greater visibility during dusk and darkness, decorate or trim costumes with reflective tape that will glow in the beam of a car’s headlights. Bags or sacks should also be light colored or decorated with reflective tape. Reflective tape is usually available in hardware, bicycle, and sporting goods stores.
  • Bring a flashlight and cell phone with you.

Choose Safe Houses

  • Children should go only to homes where the residents are known and have outside lights on as a sign of welcome.
  • Children should not enter homes or apartments unless they are accompanied by an adult.
  • People expecting trick-or-treaters should remove anything that could be an obstacle from lawns, steps and porches.

Image result for jack-o-lanternSmart Jack-o’-lanterns

  • Use a flashlight, battery tea light or flameless candle to light your jack-o’’-lantern.

When carving pumpkins:

    • Carve pumpkins on stable, flat surfaces with good lighting.
    • Have children draw a face on the outside of the pumpkin, then let an adult do the cutting.
    • Place lighted pumpkins away from curtains and other flammable objects, and do not leave lit pumpkins unattended

 

RESOURCES:

American Academy of Pediatrics
http://www.aap.org

 

#TOCA #TOCAMD #Halloween #HalloweenSafety #KidSafe #MyOrthoDoc #HalloweenFun #Trickortreat #Halloweencostume #Holidays #Celebrate #HappyHalloween

Rotator Cuff Repair – Dr. Harmsen

From conservative treatment options to more advanced surgical techniques (rotator cuff repair)

*Credit Honor Health, featuring Dr. Harmsen

Shoulder pain that increases with motion, awakens one from sleep or is associated with weakness may be a sign of a torn rotator cuff. Whether the pain is caused by a sudden injury or develops gradually over time, treatment options for a rotator cuff tear are available at HonorHealth and can effectively reduce discomfort, improve range of motion and build shoulder strength.

Degenerative wear and tear

The rotator cuff is made up of four muscles that attach and create a cuff around the ball of the ball and socket joint of the shoulder. This cuff helps stabilize the ball and socket joint, allowing one to lift and rotate the arm.

A rotator cuff tear is a common cause of pain and disability, accounting for almost 2 million people in the United States who went to their doctor in 2013 because of a rotator cuff problem, according to the American Academy of Orthopaedic Surgeons.

“As we get older, we naturally experience some extent of rotator cuff wear and tear, which often occurs slowly, usually by age 60,” said Samuel Harmsen, M.D., an orthopedic surgeon and shoulder and elbow specialist at HonorHealth Greenbaum Surgical Specialty Hospital. “A rotator cuff tear is generally more prevalent in those who are active, but can also be attributed to family history, age, arthritis, or even smoking.”

Although not all individuals with rotator cuff tears develop symptoms, many experience shoulder pain, irritation, inflammation and weakness, which can be very debilitating.

“Patients often experience pain with activities such as throwing, lifting or lowering the arm, or even simple tasks such as putting the dishes away,” Harmsen said. “Night pain that awakens one from sleep is also very common.”

Treatment typically begins with a more conservative approach and may include a combination of physical therapy, activity modification, over-the-counter pain medication and steroid injections to alleviate pain and improve function.

“Our goal is to manage symptoms, increase function and stabilize the shoulder joint to improve quality of life,” Harmsen explained.

In about 80 percent of patients, nonsurgical treatment relieves pain and improves function in the shoulder, according to the American Academy of Orthopaedic Surgeons.

“When conservative management is no longer successful, surgery would be the next recommended step,” Harmsen added.

Acute injuries

A rotator cuff tear can also occur suddenly, while playing sports, lifting too much weight or after a bad fall. If the tear occurs with an injury, individuals may experience acute pain, a snapping sensation, and immediate weakness of the arm, according to the American Academy of Orthopaedic Surgeons.

“While an acute rotator cuff tear can happen to anyone, most injuries occur in younger and more active patients,” Harmsen explained. “Injuries are often associated with strenuous activities that cause a sudden pull or stress to the shoulder. Shoulder dislocations can also result in acute rotator cuff injuries in older patients.”

Surgical treatment

Experts say that if a rotator cuff tear is not treated, it could be more difficult to repair over time and symptoms may worsen. Depending on the timing of the injury, size and shape of the tear, a person’s age, their activity level and overall health, surgical intervention may be necessary.

The orthopedic surgeons at HonorHealth have access to the latest technology and can perform both traditional and minimally invasive surgical techniques to repair a torn rotator cuff.

“Arthroscopic surgery is a more advanced approach that utilizes a small camera which allows greater visualization of the shoulder joint to better understand the nature of the tear,” Harmsen explained. “Because of this less invasive technology, we are able to make smaller incisions that result in less postoperative pain.”

Other techniques, including superior capsular reconstruction and reverse shoulder arthroplasty, are sometimes used after multiple surgical attempts have been unsuccessful, if the rotator cuff cannot be repaired or when arthritis is present. These more advanced techniques are also available at HonorHealth.

Recovery

After surgery, patients often use a sling during a period of immobilization to keep their arm in a protected position, followed by physical therapy and home exercises to improve range of motion and regain strength.

“Most patients do very well with surgical intervention,” Harmsen said. “While some early stiffness is expected, the results often lead to resolution of pain and improved shoulder function.”

Experts say it takes approximately 12 weeks to heal before patients can return to activities of daily living.

“Improvements to overall shoulder health, pain and function can continue for up to a year after surgery,” Harmsen added.

Learn more about rotator cuff treatment options at HonorHealth.

 

To learn more about shoulder injury prevention tips click Here. To learn more about Dr. Harmsen click Here. To learn more about TOCA’s shoulder specialists click Here

 

#Recovery #Results #Relief #MyOrthoDoc #DrHarmsen #TOCA #TOCAMD #ShoulderPain

 

The Orthopedic Clinic Association names John Kinna Chief Executive Officer

The Orthopedic Clinic Association

FOR IMMEDIATE RELEASE

October 6, 2017
Media Contact: Lisa Paulson, Director of Marketing
lpaulson@tocamd.com; Office: 602.512.8525; Cell: 602.501.7583

The Orthopedic Clinic Association names John Kinna Chief Executive Officer

TOCA – The Orthopedic Clinic Association, a leading Orthopedic Clinic in Arizona, led by nationally recognized Orthopedic Physicians, has appointed John Kinna as Chief Executive Officer, effective October 2, 2017.

“John Kinna has a distinguished record of accomplishment and dedication to the critically important role of Orthopedics. “As we plan for the future, Kinna’s commitment to combining the highest levels of quality with outstanding patient experience will help achieve TOCA’s inspiring vision for the future,” said Joseph Haber, M.D., President of The Orthopedic Clinic Association. “John will build on the many strengths of the past and we are confident he will ably lead the association into the future.”

“TOCA is a trusted and admired, one stop resource for Orthopedics in Arizona. It is a tremendous opportunity for me to join an organization as distinguished as they are. I’m eager to work with TOCA’s skilled and respected physicians’ and staff, and together provide the best possible patient experience and outcomes.

Kinna has worked in healthcare for the past 29 years in leadership and management roles in both not for profit and for profit systems in Montana, Washington and now Arizona, including private practices, and large integrated groups as well as two large Catholic healthcare systems running employed Physician Divisions. He has served as the CEO at Barrow Brain and Spine and most recently at OrthoArizona.

About TOCA – The Orthopedic Clinic Association

TOCA (The Orthopedic Clinic Association) is the best one stop resource for orthopedics in Arizona, led by nationally recognized orthopedic physicians. We are passionate about consistent quality, the most advanced treatment options and personalized patient care for superior lifetime outcomes.

TOCA has built a reputation for excellence in Arizona for more than 65 years as the first and foremost orthopedic group. Our Nationally and Internationally recognized orthopedic physicians and surgeons utilize the most advanced proven technologies for the best recovery possible to return you to your active lifestyle.

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To learn more about TOCA’s physicians read more Here. For more information on TOCA’s history read more Here. To contact TOCA find more information by clicking Here

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD #JohnKinna #NewCEO

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Celebrate National PA (Physician Assistant) Week October 6 – 12th!

Each year from October 6-12, we celebrate National PA Week, which recognizes the PA profession and its contributions to the nation’s health.

This week is also an opportunity to raise awareness and visibility of the profession. Before it was a weeklong event, National PA Day was first celebrated on October 6, 1987, in honor of the 20th anniversary of the first graduating class of PAs from the Duke University PA program. October 6th is also the birthday of the profession’s founder, Eugene A. Stead, Jr., MD. Now the profession is 50 years strong!

History of the PA Profession

The PA profession was created to improve and expand healthcare.

In the mid-1960s, physicians and educators recognized there was a shortage of primary care physicians.

To help remedy this, Eugene A. Stead Jr., MD, of the Duke University Medical Center, put together the first class of PAs in 1965. He selected four Navy Hospital Corpsmen who had received considerable medical training during their military service. Stead based the curriculum of the PA program on his knowledge of the fast-track training of doctors during World War II.

The first PA class graduated from the Duke University PA program on Oct. 6, 1967.

The PA concept was lauded early on and gained federal acceptance and backing as early as the 1970s as a creative solution to physician shortages. The medical community helped support the new profession and spurred the setting of accreditation standards, establishment of a national certification process and standardized examination, and development of continuing medical education requirements.

What is a PA? (American Academy of PAs)

What is a PA?

A physician assistant (or PA) is a nationally certified and state-licensed medical professional. There are currently more than 100,000 clinically practicing PA’s in the United States! PA’s practice medicine on health care teams with physicians and other providers. They also prescribe medication in all 50 states.

 

What does a PA do? Well, at the most basic level, a PA is a medical practitioner who works under the supervision of a physician.

Physician assistants (PAs) work closely with doctors and handle duties that range from taking medical histories to setting simple fractures. They are allowed to prescribe medications in some states. Many PAs specialize in a particular area of medicine, such as pediatrics. A master’s degree is required, and all states require that PAs be licensed. Licensing requires passing a multiple-choice exam and completing continuing education courses to keep knowledge current.

Beyond the basic definition, however, the PA profession represents an essential part of the health care infrastructure in a number of important ways.

Physician assistants examine, diagnose and treat patients under the supervision of licensed physician. PAs can prepare casts or splints, suture small wounds and interpret medical tests. According to the American Academy of Physician Assistants (AAPA), these medically-trained professionals can also prescribe medications (www.aapa.org).

Some PAs specialize in a particular area of medicine, such as emergency care or geriatrics, and can assist doctors in advanced medical techniques and procedures. Physician assistants are often the first line of medical care in rural and underserved areas. In some cases, a physician assistant will refer the patient to a medical doctor or make arrangements for transferring the patient to a hospital or clinic.

During this week, TOCA is excited to honor our amazing PAs and to say a big thank you. We appreciate your dedication to patient care, and we recognize the impact that you make in the lives of those patients every day.

To read more about the dedicated Physician Assistant staff at TOCA Click Here

To learn more about TOCA or to schedule an appointment call 602-277-6211

 

#Recovery #Results #Relief #TOCA #TOCAMD #PA #PAWeek #ThankAPA #Patientcare #PhysicianAssistant #PADay #MyOrthoDoc

Total Elbow Replacement: What you need to know

Total Elbow Replacement

The elbow is a necessary joint for normal functioning in daily life, yet it is susceptible to various degenerative conditions and traumatic lesions or posttraumatic sequelae.  Although a total elbow replacement is much less common than knee or hip replacement, it is just as successful in relieving joint pain and returning people to activities they enjoy.

Elbow replacement surgery is a complicated procedure partly because the elbow has several moving parts that balance each other with great precision to control the movements of your forearm.

Your elbow can be damaged by problems ranging from rheumatoid arthritis to traumatic fractures. In some cases, the damage can be surgically repaired. But if the damage is extensive, your doctor might recommend elbow replacement surgery. Pain is the most common reason people choose to have elbow replacement surgery.

Over 3,000 people in the U.S. have elbow replacement surgery annually, according to the Agency for Healthcare Research and Quality.

Whether you have just started exploring treatment options or have  decided to have an elbow replacement surgery, this article will help you understand more about this valuable procedure.

Anatomy

The elbow is a hinge joint which is made up of three bones:

  • The humerus (upper arm bone)
  • The ulna (forearm bone on the pinky finger side)
  • The radius (forearm bone on the thumb side)

The surfaces of the bones where they meet to form the elbow joint are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily. A thin, smooth tissue called synovial membrane covers all remaining surfaces inside the elbow joint. In a healthy elbow, this membrane makes a small amount of fluid that lubricates the cartilage and eliminates almost any friction as you bend and rotate your arm.

 

Muscles, ligaments, and tendons hold the elbow joint together.

 

(The main structures of the elbow when viewed from the side.)

Types of elbow replacement

In some cases, you may need a replacement of just one portion of the joint. For example, if only the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head.

If the entire joint needs to be replaced, the ends of the bones that come together in the elbow will be removed. Bones are hard tubes that contain a soft center. The long, slender ends of the artificial joint are inserted into the softer central part of the bones.

There are two main types of prosthetic devices available:

  • Linked. This type of prosthesis acts somewhat like a loose hinge because all the parts of the replacement joint are connected. This provides good joint stability, but the stresses of movement can sometimes result in the prosthesis working itself loose from where it’s inserted into the arm bones.
  • Unlinked. This type of device comes in two separate pieces that aren’t connected to each other. This design depends on the surrounding ligaments to help hold the joint together, which can make it more prone to dislocation.

Description

In total elbow replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components. The artificial elbow joint is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone called the canal.

(Total elbow replacement components.)

There are different types of elbow replacements, and components come in different sizes. There are also partial elbow replacements, which may be used in very specific situations. A discussion with your doctor will help to determine what type of elbow replacement is best for you.

 

Causes

Several conditions can cause elbow pain and disability, and lead patients and their doctors to consider elbow joint replacement surgery.

Rheumatoid Arthritis

This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness.

Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”

Osteoarthritis (Degenerative Joint Disease)

Osteoarthritis is an age-related, “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the elbow softens and wears away. The bones then rub against one another. Over time, the elbow joint becomes stiff and painful.

Rheumatoid arthritis and osteoarthritis cause cartilage damage that can result in severe pain and disability.

Post-traumatic Arthritis

This type of arthritis can follow a serious elbow injury. Fractures of the bones that make up the elbow, or tears of the surrounding tendons and ligaments may cause damage to the articular cartilage over time. This causes pain and limits elbow function.

Severe Fractures

A severe fracture of one or more bones that make up the elbow is another common reason people have elbow replacements. If the elbow is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. In this type of case, a surgeon may recommend an elbow replacement. Older patients with osteoporosis (fragile bone) are most at risk for severe elbow fractures.

In addition, some fractures do not heal well and may require an elbow replacement to address continuing problems.

Instability

Instability occurs when the ligaments that hold the elbow joint together are damaged and do not work well. The elbow is prone to dislocation. Chronic instability is most often caused by an injury.

 

Teamwork

TOCA’s treatment teams include specialists in orthopedic surgery and in physical medicine and rehabilitation. These experts work together with the goal of restoring strength and range of motion in your elbow.

 

Diagnostic and surgical innovation

TOCA’s physicians  have developed several diagnostic examinations and surgical techniques to help make elbow replacement a highly effective treatment option.

Table. Treatment Options for Elbow-Related Problems

Affected joint(s) Options Plain radiographs
Radial head Radial head replacement Figure 1
Ulna Total elbow arthroplasty Figure 2
Humeroradial Radial head replacement Figure 1
Unicompartmental replacement Figure 3
Humeroulnar Total elbow arthroplasty Figure 2
Humerus Hemiarthroplasty Figure 4
Radioulnar Radial head replacement Figure 1
Radial head resection

Preparing for Surgery

Medical Evaluation

If you decide to have elbow replacement surgery, your orthopaedic surgeon at TOCA may ask you to schedule a complete physical examination with your family physician several weeks before surgery. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process.

Many patients with chronic medical conditions, like heart disease, must also be evaluated by a specialist, such a cardiologist, before the surgery.

Medications

Be sure to talk to your orthopaedic surgeon and TOCA medical team about the medications you take. Some medications may need to be stopped before surgery. For example, the following over-the-counter medicines may cause excessive bleeding and should be stopped 2 weeks before surgery:

  • Non-steroidal anti-inflammatory medications, such as aspirin, ibuprofen, and naproxen sodium
  • Most arthritis medications

If you take blood thinners, either your primary care doctor or cardiologist will advise you about stopping these medications before surgery.

Home Planning

Making simple changes in your home before surgery can make your recovery period easier.

For the first several weeks after your surgery, it will be hard to reach high shelves and cupboards. Before your surgery, be sure to go through your home and place any items you may need afterwards on low shelves.

When you come home from the hospital, you will need help for a few weeks with some daily tasks like dressing, bathing, cooking, and laundry. If you will not have any support at home immediately after surgery, you may need a short stay in a rehabilitation facility until you become more independent.

 

Your Surgery

Before Your Operation

You will most likely be admitted to the hospital on the day of your surgery. After admission, you will be taken to the preoperative preparation area and will meet a doctor from the anesthesia department.

You, your anesthesiologist, and your surgeon will discuss the type of anesthesia to be used. In most total elbow replacement surgeries, a general anesthetic that puts you to sleep for the entire operation is used.

Surgical Procedure

To reach the elbow joint, your surgeon will make an incision (cut), usually at the back of the elbow. After making the incision, your surgeon will gently move muscles aside to get access to the bone. After removing scar tissue and spurs around the joint, your surgeon will prepare the humerus to fit the metallic piece that will replace that side of the joint. The same preparation is done for the ulna.

The replacement stems are placed into the humerus and ulna bones, and kept in place with a bone cement. The two stems are connected by a hinge pin. After the wound is closed, a padded dressing is then placed to protect the incision while it heals.

Some surgeons will place a temporary tube in the joint to drain the surgical fluid. This tube can be easily removed in your hospital room within the first few days after surgery.

 

Implants

The metal replacement parts are made of chrome-cobalt alloy or titanium and there is a liner made of polyethylene (plastic). The bone cement is made of polymethylmethacrylate (acrylic, a type of plastic).

Recovery

Your medical team will give you several doses of antibiotics to prevent infection. Most patients are able to eat solid food and get out of bed the day after surgery. You will most likely stay at the hospital 2 to 4 days after your surgery.

Pain Management

After surgery, you will feel some pain, but your surgeon and nurses will provide medication to make you feel as comfortable as possible. Talk with your surgeon if postoperative pain becomes a problem.

Rehabilitation

A careful, well-planned rehabilitation program is critical to the success of an elbow replacement. You will be taught some exercises for your hand and wrist to avoid stiffness and help to control swelling. You will do gentle elbow range-of-motion exercises as the incision heals. Your doctor may prescribe therapy or may teach you how to do the exercises yourself.

You will most likely not be allowed to put any weight on your arm or push against resistance with your hand until about 6 weeks after your surgery.

Long-Term Outcomes

The majority of patients have experienced an improved quality of life after total elbow replacement surgery. They experience less pain, improved motion and strength, and better function.

You should expect to do all basic activities of daily living, such as getting a plate out of a cabinet, cooking dinner, lifting a milk jug, styling your hair, basic hygiene, and dressing. Talk to your doctor about activities you may want to avoid, such as contact sports and activities with a major risk of falling (such as horseback riding or climbing ladders), as well as heavy lifting. These things increase the risk of the metal parts loosening or breaking, or the bone breaking.

When traveling on airplanes, be prepared for extra security screening. There is a chance that your metal implant will set off the metal detector during the security check-in.

To make the check-in go more smoothly, tell the security officer beforehand that you have an elbow replacement and carry a medical identification card. Although this does not change the screening requirements, it will help the security officer confirm the nature of the alarm. Be prepared for the security officer to use a wand scanner, and perhaps examine your arm in a private area in order to see the scar. The new body scanners can identify joint replacements, making further individual screening unnecessary.

 

If you are experiencing pain from an elbow injury or chronic condition schedule an appointment with an Orthopedic Specialist at TOCA by calling 602-277-6211!

 

#Recovery #Results #Relief #MyOrthoDoc #ElbowSurgery #ElbowPain #TOCA #TOCAMD