Blog Posts

Glioblastoma: A Ghastly Cancer

September 11th, 2018

On Saturday, Aug 25, Arizona Senator John McCain succumbed to an especially heinous brain cancer called glioblastoma. Glioblastoma, the most common of all of the malignant primary brain tumors, is the same illness that killed Sen. Ted Kennedy and Beau Biden, the son of former Vice President Joe Biden.

John Sidney McCain III (August 29, 1936 – August 25, 2018)

In the United States, there are approximately 18,000 people diagnosed with glioblastoma every year, and an estimated 13,000 die from it annually. As you can see, glioblastoma is a very deadly disease. It is a primary tumor because it starts in the cells of the central nervous system, the brain and spinal cord, and quickly spreads to other cells in the brain.

Glioblastoma is more common in men than in women, and the chances of getting it increase with age. Glioblastoma tumors tend to occur in adults between 45 and 70 years old. A study conducted between 2005 and 2009 found that the median age group for death from brain and other central nervous system cancers was 64.

There are two main types of cells in the brain: neurons, which transmit messages from cell to cell, and glial cells, which provide support to neurons and help regulate the transmission of those messages. Glioblastomas start in the star-shaped glial cells called astrocytes. The tumors generally begin in the cerebrum, the largest part of the brain.

A glioblastoma tumor is highly malignant, or able to spread, because it can rapidly invade nearby healthy brain tissue. As the tumor grows, it puts increasing pressure on the brain, which leads to various symptoms. These include headaches, blurred or double vision, difficulty thinking or remembering, changes in mood or personality, seizures, vomiting and trouble speaking.

In most cases, the exact cause of glioblastoma is not known. In rare cases, it can occur in people with certain genetic syndromes. In these cases, the affected people typically also have additional symptoms characteristic of those syndromes. Those syndromes are generally caused by mutations to a specific gene.

Diagnosing glioblastoma begins with a history of symptoms and a full physical exam. Your doctor will likely order an imaging test, most commonly an MRI. The MRI can show the size and location of the tumor. Your doctor may also perform a biopsy, the removal of a sample of  tumor tissue to study under a microscope.

If you are healthy enough to have a procedure, treatment for glioblastoma will begin with surgery to remove the tumor. Due to the location of the tumor and how far it has invaded into healthy brain cells, doctors are often unable to remove the entire tumor. However, removing as much as possible, or debulking it, can release some of the pressure on the brain and help reduce symptoms.

Following surgery, you will be given radiation therapy and chemotherapy. Radiation therapy uses high-energy beams, such as x-rays or protons, to kill cancer cells remaining after surgery. Chemotherapy uses drugs to kill cancer cells. For people who are unable to undergo surgery, radiation therapy and chemotherapy are the primary treatments for glioblastoma.

Newer treatments that have been showing promise are biological therapies. These therapies target the specific biological functions that are essential for the tumor to grow. They are also designed to be less toxic to healthy cells than radiation therapy and chemotherapy.

Often, glioblastoma tumors return after treatment. If this happens, you can repeat the cycle of surgery, radiation and chemotherapy. You may also want to consider a clinical trial of a new treatment still in the testing phase. Ask your doctor about available clinical trials in your area or visit

Your doctor may also recommend palliative care. This is a specialized type of medical care that aims to provide relief from your pain and other symptoms. The palliative care doctors work with you, your family and your cancer specialists to provide care that complements any other treatment you may be receiving.

Unfortunately, because glioblastoma is such a malignant and aggressive cancer, the outlook for those affected by it is not promising. There is currently no cure for the disease, and many people who get it live less than a year after their initial diagnosis. Currently, the median survival for adults with aggressive glioblastoma is approximately 14.6 months. The two-year survival is 30 percent. Thank God this is a relatively rare cancer.

Don’t be a Tech Neck

September 4th, 2018

A YouTube video showing people walking into everything from doors and walls to cars and fountains while looking down at their cell phones has drawn hundreds of thousands of online views and at least that many laughs.

The potential for injury stemming from staring at your cell phone is no laughing matter, however, and the dangers extend beyond the possibility of stumbling or falling as a result of simply not paying attention to what you’re doing while on your phone.

Staring down at your cell phone for extended periods of time can also lead to some painfully serious medical conditions, including a few that are tied exclusively to the simple way in which most of us typically look at our cell phones.

Tech Neck, Text Neck and the Smart Phone Slump are some of the names of these conditions, and they are all byproducts of the stresses that are placed on our head, neck and shoulders when we assume this seemingly standard posture.

For most, that posture includes simply looking down, but a study conducted by, Dr. Kenneth K Hansraj, the chief of spine surgery at New York Spine Surgery and Rehabilitation Medicine, found that the stress created by that posture is significant.

For example, when we stand upright and hold our head in the neutral or straight-up position, 10-12 pounds of force is placed on the neck and cervical spine. That force increases dramatically, however, with every degree with which we tilt the head forward.

By tilting the head forward just 15 degrees, the force on the neck muscles and cervical spine more than doubles to 27 pounds. At 30 degrees of tilt the force increases to 40 pounds and at 60 degrees, where the chin is nearest the chest, the force is 60 pounds.

Stay in that position long enough or assume it often enough as cell-phone users often do and the resulting damage to those areas of the body can include intermittent or constant neck, shoulder and back pain and headaches.

For some, these symptoms are so severe that a doctor’s care is required to correct them. Others may be able to correct them by doing a few simple home exercises such as placing your hands behind your head, opening your elbows wide and looking upward.

As is often the case, though, the best remedy is prevention. With that in mind here are five simple tips – courtesy of – to follow that can help you prevent Tech Neck, Text Neck, Smart Phone Slump and other related problems.

  1. Set time limits.Limit the amount of time and frequency that you use your device. If you have to use it for an extended period of time, take breaks. Develop a habit of taking a three-minute break for every 15-20 minutes you use your device. Change your posture and move around.
  2. Set automatic reminders.Utilize an automatic alarm with your smart device reminding you to take a time out. For those of you that have wearable devices these can be set to remind you to break, such as the iWatch which can tap you every 15-20 minutes.
  3. Use a tablet holder.Purchase a holder to elevate your device to significantly reduce the amount of neck flexion and forward positioning. Try to keep the device as close to eye-level as possible. This is a great tool to reduce Tech Neck.
  4. Sit in a chair with a headrest.Switch to a chair with a headrest and make sure to keep the back of your head in contact with the headrest while using your tablet, phone or laptop. Keeping the back of your head flush against the headrest will ensure that you’re not looking down with your neck flexed forward.
  5. Use pain as a warning.If you’re experiencing neck pain between the shoulder blades, numbness or tingling in the arms or frequent headaches there may be a more serious issue going on. Pay attention to these warning signs and act quickly to make changes to reduce or eliminate any head-forward posture that is straining your neck.

Bye-Bye Vertigo!

August 28th, 2018

Living in Florida can be brutal for an allergy sufferer. I know, because I’ve lived in Florida since I was three and can’t remember a time when I didn’t suffer from allergies and ear and nasal infections. I’m allergic to the world so I’m always having to make trips to the doctor for antibiotics and allergy treatments.Photo from

Recently, I started getting frequent dizzy spells as well. I assumed at first that they were the result of another infection and put off doing anything about it. But then the dizzy spells became more severe and quite random. They would occur almost anytime, anywhere.

At first, they lasted only for a few seconds. But then, about a month ago, I woke up one morning feeling very dizzy, and as I started to move around, the dizziness did not let up at all. In fact, it only got worse, to the point where I didn’t feel safe driving myself to work.

I struggled through that entire day, literally using the walls in the hallway to hold me up because my balance was terrible, and I didn’t trust myself not to fall. After another couple days of feeling like this, I ended up having to miss a day of work.

It was at that point that I finally gave in and went to see a doctor. I was feeling anxious before my appointment, not knowing exactly what was going on at this point or how it would be diagnosed or treated, but then, after the doctor did a few maneuvers on me, he said, You have vertigo.

He explained briefly what vertigo is and provided a video for me to watch. At first, I thought, A videoHow is a video going to help me? But he was right. The video was extremely informative and explained in detail what vertigo is while also providing a detailed demonstration of how to treat it.

I went home and started following the protocol from the video right away. By the next morning, I was feeling much better. The treatment helped rid me of the dizziness and changed my life. If it ever comes back again, I will know exactly what to do. I hope this video helps you as much as it did me.


Through The Eyes Of A Child

August 13th, 2018

Waiting until after Labor Day to begin the new school year is a thing of the past. It is here in Florida anyway. Students attending public schools in the Sunshine State return to school a full three weeks before the Labor Day holiday this year.

With the summer break now at an end, the time for back-to-school shopping is already at hand. So, too, is the time to make sure your child is as well-equipped as possible to begin the new school year right.

Being properly equipped for school doesn’t just mean having the right notebooks, paper and pencils, however. It also means being in the proper physical state to succeed, which is why August has been designated Children’s Eye Health and Safety Month.

For anyone with school-aged children, it is always a good idea to devote a small part of the summer to getting your children’s eyes examined so that any issues can be corrected long before the first homework assignment is handed out.

Through a brief eye examination, an ophthalmologist can not only detect common issues such as nearsightedness, farsightedness and astigmatism but less common diseases such as amblyopia (lazy eye), ptosis (drooping eyelids) and color blindness.

It’s also possible for parents, friends and family members to detect potential vision issues. Wandering or crossed eyes are easily detected while complaints of sore eyes or headaches from reading, watching TV or playing video games can be a sign of trouble, too.

There’s more to good eye care, though, than just getting an eye exam. Parents should also do everything they can to make sure their son or daughter is taking steps each day to avoid physical damage to their eyes.

For example, it’s just as important for your school-aged son or daughter to wear sun glasses on a bright, sunny day as it is for you. And wearing protective eyewear during sporting and recreational activities should always be recommended, if not insisted upon.

Many children may choose to ignore such recommendations, but before they do, they should know that children suffer the majority of the approximately 42,000 sports-related eye injuries that occur every year in the United States alone.

With the school year already beginning, it’s wise to take steps now to ensure they are fully dressed for success.

A Bit About OAB

August 13th, 2018

Overactive bladder or OAB, isn’t a disease in itself. Rather, it’s a syndrome, a collection of symptoms caused by sudden, involuntary contractions of the muscle of the wall of the bladder, where urine is stored. OAB symptoms can be triggered anywhere at any time and can have a major impact on your quality of life.

The most notable symptom of OAB is a sudden need to urinate that you can’t control. Some of us leak urine when we feel this sudden urge. That’s called urge incontinence, and like stress incontinence, it’s a pain in the keister. Having to go to the bathroom a lot during the day and two or more times at night are other common symptoms of OAB. Unlike urinary tract infections, there’s no pain or burning when you urinate, and there’s no blood in your urine with OAB.

OAB is very common. The American Urological Association says about 33 million Americans suffer with it. The fact is, as many as 30 percent of men and 40 percent of women in this country live with OAB symptoms. Keep in mind that many people who have OAB symptoms don’t tell their doctors because they’re embarrassed, so the actual number of people who have OAB is probably a lot higher than estimates suggest.

Age is a risk factor for OAB. It’s more common as we get older, but it’s not a normal part of aging. It’s also more common in people who have weak pelvic muscles, nerve damage or urinary tract infections. Certain medications and fluids, such as alcohol and beverages with caffeine, can be irritating to the bladder, as can excess weight. The loss of estrogen in menopause put women at a higher risk for OAB.

If you have the annoying symptoms of OAB, swallow your pride and tell your doctor, especially if the problem is affecting your daily functioning. People with OAB tend to avoid going too far from a toilet, so they start skipping social functions and events for fear they won’t have access to a bathroom. Staying home alone all the time can ultimately lead to feelings of isolation and depression. You don’t want that!

Don’t despair, there are treatments available. Most doctors start treatment with behavior modification. This includes monitoring your diet for any foods and drinks that can made bladder symptoms worse. Other aims include treating constipation and getting regular, and maintaining a healthy weight. Giving up smoking and drinking plenty of fluids that don’t irritate the bladder are also steps m this process.

Bladder retraining is another approach to OAB treatment. This involves scheduling times to go to the bathroom instead of going when the urge is felt. You then slowly increase the time between bathroom visits. In addition, doing specialized Kegel exercises strengthens the muscles of the pelvic floor, which control urination.

If these conservative measures fail to relieve your OAB symptoms, your doctor may prescribe a medication. Most medications used for OAB control the muscle spasms in your bladder, which decreases the symptoms of urgency and frequency to urinate.

If medications don’t help you or if you can’t tolerate their side effects, an injection of BOTOX into the bladder muscle may be an option. BOTOX temporarily paralyzes the  muscle, stopping its contractions, which in turn, stops the OAB symptoms. The results of BOTOX therapy lasts anywhere from four to eight months. The injection can be repeated.

Two types of neuromodulation or direct nerve stimulation are also available to treat OAB. They are percutaneous tibial nerve stimulation (PTNS) and sacral neuromodulation. These treatments work by reorganizing the spinal reflexes involved in bladder control. When all else fails, reconstructive bladder surgery may be an option, although surgery is rarely necessary.

Take heart. If you have OAB, your outlook is good. For most people, the combined approach of behavior modification and medication significantly improves urinary symptoms and your quality of life.


Studying Psoriasis

August 4th, 2018

August is one of the hottest months of the year for nearly everybody, so it’s a great time to stay in the air conditioning and get a little education. This week’s lesson is on psoriasis, a chronic condition that’s more than skin deep. Research shows it’s the result of several factors, including your immune system, genetics and environmental exposure.

There are different types of psoriasis, but I’m going to concentrate on the most common form, plaque psoriasis. The American Academy of Dermatology reports that about 80 to 90 percent of people with psoriasis develop this form. With plaque psoriasis, people get red, itchy patches on their skin called plaques.

So, where do these plaques come from? Well, normally, the life cycle of skin cells involves producing new skin cells and shedding the old. This cycle takes about a month to complete. With plaque psoriasis, your immune system goes into overdrive and triggers inflammation, causing the skin to produce new cells double quick.

So, the skin cell life cycle gets cut to about a week instead of a month. The problem is the skin can’t shed the old, dead cells that fast. Instead, the old cells pile on top of each on the surface of the skin, forming the thick, red, flaky plaques. Often, the plaques get thin, dry, silvery scales on them. The skin around them might burn or be painful or crack and bleed.

The plaques can form anywhere on your body, but the most common locations are the knees, elbows, torso and scalp. They tend to vary in size, and can appear as a single spot or as a cluster that covers a large area of your body. Most people who have psoriasis have it their entire lives, but it generally clears up for a while then flares up again.

There are many things that can cause your psoriasis to flare. Some people carry one or more genes linked to the development of psoriasis. One out of three people with the condition have a relative who also has it. However, not everyone with these genes gets the disease. It’s believed that certain environment factors trigger the genes and result in the disease becoming active.

There are a number of outside factors that trigger a psoriasis flare or worsen one in progress. Some of the more common triggers include infection such as strep throat, injury to the skin, smoking, changes in the weather, heavy alcohol use, a deficiency in Vitamin D, stress, and medications, including lithium, iodides, and certain blood pressure and antimalarial drugs. Identifying your triggers and avoiding them is one way to help manage your psoriasis.

Your dermatologist can usually diagnose psoriasis by asking you questions about your medical history and symptoms, then examining your skin. He or she may take a small sample of affected skin to examine under the microscope. This may be done to rule out other skin disorders as well as to confirm the psoriasis diagnosis and determine the type of psoriasis.

Following diagnosis, your doctor will develop a treatment plan. The plan usually begins with topical creams and ointments, especially if you have mild to moderate disease. These treatments include topical corticosteroids, Vitamin D and retinoids.

If your disease is more severe or you don’t respond to the topical creams, your dermatologist may try phototherapy or oral or injected medications that work throughout your body. Phototherapy uses natural or artificial ultraviolet light to slow the creation of new skin cells. Your doctor may try a systemic oral medication such as methotrexate or cyclosporine, or an injected biologic such as Humira, Cosentyx, Stelara or Taltz to clear your skin from a flare.

In March of this year, a new, purportedly more powerful drug was approved by the FDA for the treatment of adults with moderate to severe plaque psoriasis. It’s called tildrakizumab-asmn or Ilumya. It became available by prescription in the US earlier this summer.

Ilumya, an injection administered every 12 weeks, is approved for patients who are candidates for systemic medications or phototherapy, according to its manufacturer Sun Pharmaceuticals. The drug works to reduce inflammation by inhibiting the release of certain pro-inflammatory substances from the immune system called cytokines.

Identifying your triggers and following your doctor’s treatment plan are both important for managing your psoriasis. Here are a few more suggestions that also might help:

  • Avoid skin injuries. Be more careful when working and shaving (men and women) to avoid nicks and cuts, and be sure to use insect-repellant outdoors to prevent bug bites.
  • Get a small amount of sunlight, but don’t get burned. A brief period in the sun can help improve your psoriasis, but too much can trigger or worsen a flare, not to mention put you at greater risk for skin cancer.
  • Soak in a lukewarm tub every day. Put colloidal oatmeal, Epsom salts or Dead Sea salts in the water to calm inflamed skin. Don’t use very hot water or harsh soaps. Mild soap has oil and fat that can help soothe your skin. Pat yourself dry after soaking about ten minutes.
  • Limit your alcohol intake. Alcohol can be a trigger, and it can decrease the effectiveness of many of the medications used to treat psoriasis. If you drink, do it in moderation.
  • Control stress. Stress can be a trigger and it can make managing psoriasis more difficult. Take time in your day to relax. Try a relaxation techniques such as yoga, meditation or deep breathing. If you need more help de-stressing, talk to your doctor.
  • Exercise and Eat Healthy. A healthy lifestyle is good for you in general and can help you maintain a positive attitude. That positivity will make you stronger and more capable of managing your psoriasis on a daily basis.

Concentrating on ADHD in Adults

July 31st, 2018

The national nonprofit organization Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) estimates 10 million adults have ADHD. We hear more about ADHD in children, but 30 percent to 70 percent of kids with the disorder continue having symptoms into adulthood. In adults, ADHD affects men and women equally.

ADHD is a developmental disorder that has emotional, intellectual, behavioral and physical symptoms. These symptoms include distractibility, impulsivity and hyperactivity. They can cause problems in your relationships, as well as your ability to function at work or socially.

Some signs that an adult may have ADHD are commonplace behaviors, so their significance in many cases is not recognized. Aa a result, ADHD in adults often goes undiagnosed.

Common signs of ADHD in adults include chronically running late and driving haphazardly, because they can’t keep their minds on their current task. Problems with self-control, including outbursts of anger or insulting comments, are also signs of possible ADHD.

Some adults with ADHD are easily distracted and have trouble prioritizing and starting and finishing tasks. However, they may become hyper-focused on tasks they enjoy or find fun and interesting.

It’s believed that in people with ADHD, chemicals that transmit messages from brain cell to brain cell, called neurotransmitters, are less active in the parts of the brain that control attention. Thus far, researchers haven’t determined what causes this chemical imbalance in the brain. They believe that genetics may play a role in developing ADHD because the disorder often runs in families.

There are no medical diagnostic tests for ADHD. A diagnosis is generally made by a qualified physician or mental health professional using a thorough history and the guidelines outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The DSM-5 lists three presentations of ADHD, predominantly inattentive, hyperactive-impulsive and combined. The inattentive and hyperactive-impulsive presentations have their own sets of symptoms. The combined presentation has a mixture of those symptoms.

The diagnosis of ADHD in an adult is made based on the number and severity of symptoms and the extent the symptoms impact the person’s daily life. The clinician performs a thorough examination to look for other possible causes of the symptoms, as well as any co-existing conditions.

Once a diagnosis of ADHD is made, a treatment plan is created. Treatment generally involves medications, a specific type of psychotherapy or a combination of both. The type of medications most often used for ADHD in adults is a stimulant. Stimulants actually help affected adults stay focused.

The psychotherapy method most often recommended is cognitive behavioral therapy. This type of psychotherapy focuses on the thoughts and behaviors that are occurring in the present. This differs from other types of therapy that involve looking into the past and resolving emotional problems that began in childhood. CBT may help the person get organized, set helpful routines, repair relationships and improve social skills.

Adults with ADHD don’t grow out of the disorder, but with treatment, many learn to manage and cope with it. Studies show that treatment with stimulant medications and CBT often improves the outlook for adults and decreases the risk for developing other mental health disorders. It also helps people perform better in school or work.

Moving Matters

July 24th, 2018

For years, groups like the American Heart Association released guidelines for physical activity for adults. The AHA, for instance, recommends at least 30 minutes of moderate-intensity aerobic activity at least five days per week. Another option is at least 25 minutes of vigorous aerobic activity at least three days per week.Moving Matters

The old benchmark of a total of 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week rightly suggests that people get health benefits from exercise. But it added that the benefits were obtained only if the activity lasts for ten minutes or longer. Results from a study released earlier this year challenges that theory.

The study, published in the Journal of the American Heart Association, found that the length of time a person performs an activity is unrelated to the benefit of living longer. It reported that even short bursts of vigorous activity, like five minutes of brisk walking or jogging, add up to produce health benefits.

The researchers studied the activity habits and health of nearly 5,000 adults age 40 and older for four years. They gathered the participants’ activity levels through wearable tracking devices. After looking at the impact of activities as brief as one minute, the researchers discovered that all of the activity, whatever its duration, helped reap health benefits, as long as the activity reached a moderate or vigorous intensity.

To help update its own physical activity guidelines, the US Department of Health and Human Services commissioned an advisory committee to systematically review the scientific evidence on physical activity, fitness and health. The committee issued their report in March.

The committee’s findings will help HHS as they prepare their new edition of Physical Activity Guidelines for Americans. It remains to be seen if the new HHS guidelines will include the benefits of shorter bursts of activity or if it will stick to the “ten-minute rule.” The guidelines are due out later this year.

OK, let’s talk about the health benefits of adding physical activity to your weekly routine. There are lots of them, according to the US Centers for Disease Control and Prevention. The benefit most people know about is that it reduces the risk of cardiovascular diseases, mainly heart disease and stroke. What’s more, it can lower blood pressure and improve cholesterol levels.

Physical activity can help you control your weight, whether you need to lose or just maintain your weight. It can reduce your risk for developing Type 2 diabetes; and if you’ve already got it, it can help you control your blood glucose levels.

Being physically active lowers your risk of colon and breast cancer. Some studies suggest it reduces the risk of endometrial and lung cancer as well. It can keep your bones and muscles strong and even help with the pain of arthritis in your hips or knees. Stronger bones and muscles improve balance and prevent falls.

That’s not all. Physical activity can improve your mental health and your mood. It can keep your thinking sharp longer and reduce the risk for depression. When you feel better physically and mentally, you’re better able to perform your daily activities, which improves your quality of life.

Then there’s that little thing about increasing your chances of living longer. Yeah, there’s that.

The government, the American Heart Association and the study’s researchers may state it a little differently, but the message is basically the same. Getting some moderate-intensity or vigorous physical activity into your day is good for your health. Moving really does matter.

Remote Control

July 15th, 2018

Minimally invasive robotically assisted heart procedure proves effective.

Adam* describes himself as a fitness fanatic. The 55-year-old retired Naval officer works out at the gym at least five days a week and usually gets in a jog of at least five miles every other day.

He’s in excellent physical condition for a man his age, which is why he thought something must be wrong when he suddenly found himself out of breath midway through the 30 minutes it usually takes him to mow his lawn.

After taking the advice of his general practitioner and visiting a heart specialist, Adam was surprised to learn that he was suffering from mitral valve disease, which is the most common form of heart valve disease in the United States.

Nearly half a million patients are admitted to a hospital each year as a result of some form of mitral valve disease.  In turn, those visits result in approximately 40,000 Americans – most of them 50 or younger – undergoing surgery for the malady.

One of four heart valves, the mitral valve is the one that allows the blood received from the lungs to flow from the left atrium, also known as the upper chamber of the heart, to the left ventricle, or lower chamber of the heart.

What Adam learned upon his visit was that he was suffering from mitral valve regurgitation, a condition in which the mitral valve fails to close tightly when the left ventricle contracts. This failure results in a leakage or backward flow of blood through the valve.

When this leakage occurs, blood flows through the valve in both directions, causing an increase in the volume of blood in the valve as well as an increase in pressure in the atrium. This, in turn, increases the pressure in the veins leading from the lungs to the heart.

In mild cases of mitral regurgitation, sufferers may not feel any symptoms at all. In more severe cases, however, the lack of efficient blood flow can cause palpitations and may leave sufferers feeling tired and short of breath the way Adam did.

For years, the primary treatment for mitral valve regurgitation was a surgery designed to repair or replace the valve that required the surgeon to access the affected area by sawing the sternum in half, spreading the ribs and operating through the front of the chest.

As a result of advances in medical technology, however, surgeons can now perform the same operation remotely with the aid of a small camera and thin robotic arms that are fed into the body through a series of small incisions on the right side of the chest.

While the surgeon works at a computer console that provides complete control of the movement of the robotic arms, the camera provides a clear, three-dimensional view of the mitral valve and its surroundings.

Like traditional mitral valve surgery, the robotically assisted version requires general anesthesia and the use of heart-lung bypass machines to perform the functions of those organs during the procedure. It provides several advantages, however.

In addition to alleviating the need to break or cut the breastbone, the advantages of robotically assisted mitral valve surgery include less blood loss, less post-operative patient pain, less scarring and a shorter recovery time than with traditional surgery.

And research shows that robotically assisted mitral valve surgery is just as successful as the traditional option. In an NYU Langone study of 1,000 patients who had the minimally invasive surgery, their long-term clinical outcomes were equivalent to those achieved by patients who had a traditional sternotomy.DaVinci Robot Heart Valve

Adam is among those who can attest to the fact that the robotically assisted surgery works. He opted for that approach after he was told of his condition and says now that the surgery has given him a new lease on life.

“When I was told I needed to have heart surgery I wasn’t just shocked, I was scared,’’ Adam says. “Along with the concern I had for my general overall health, I was worried about the long layoff that I thought I’d be facing after surgery.

“But I was in the hospital for only two days with this new surgery and within a month of leaving, I was back working out and going through my normal routine. If had been forced to have the traditional surgery, it might have been months before I was active again.”

Need New Hip Joint?

July 9th, 2018

Positioning system makes replacement surgery more precise.

The number of Americans having hip replacement surgery has grown steadily over the past eighteen years. It’s estimated that this year, more than 300,000 people will undergo the procedure, up from 138,000 in 2000. The procedure, fortunately, has matured as well.

A recent advancement to hip replacement surgery was the release and FDA approval of a technology that helps surgeons determine the most accurate alignment of the replacement implants. This technology is the optimized positioning system or OPS™.

The inspiration behind OPS is the fact that no two people move the same way, and this can make a significant impact on the proper positioning of the hip implants. OPS is designed to account for the differences. It tailors the implant placement to each patient.

OPS factors in that no two people move the same way.

The hip joint has two essential parts, the ball and the socket. The ball of the joint is the head of the femur, or thigh bone. The socket, or acetabulum, is a concave depression in the pelvis, in which the ball sits. The ball and socket are the parts that are replaced during surgery and must be positioned appropriately for the best outcome.

To get the proper position, hip replacement surgery using OPS begins long before the procedure is performed. An extensive preoperative evaluation is first performed to determine how the patient’s femur, pelvis and spine work together during routine daily activities. This evaluation provides a specific functional simulation of the patient’s movement.

This information is essential to achieving optimum results during surgery. If the implants aren’t positioned precisely during surgery, there’s a greater risk for complications such as premature wear, implant loosening and dislocation, as well as nerve impingement.

The preoperative evaluation also includes imaging such as x-rays and CT scans to generate pictures of how the patient’s hip moves in three dimensions. The imaging captures the anatomical geometry around the person’s hip joint.

Using all of the information gathered from the preoperative evaluation, surgeons create exact 3-D models of the patients’ anatomy. They then use these models as guides to optimize implant position during the hip replacement procedure.

The preoperative evaluation is the first step in the hip replacement using OPS process. The second step is using the system during the procedure itself. During surgery, the 3-D model, which is unique to each patient, is combined with a laser guidance system. Surgeons match up the laser points to ensure the optimized plan is accurately recreated during surgery.

Need for OPS

The most common reason for needing hip replacement surgery with OPS is deterioration of the hip joint from arthritis. The most common type of arthritis is osteoarthritis, also known as “wear and tear” arthritis. Osteoarthritis generally develops with age. It’s estimated that more than 28 million Americans suffer from the disorder.

Osteoarthritis can develop in any joint in the body, but it most often affects weight-bearing joints such as knees and hips. The hip is one of the largest joints in the body, and like other joints, its surfaces are covered with a smooth cushioning material called articular cartilage. This cartilage enables the bones to slide over one another more easily.

Joints also contain another cushioning substance called synovial fluid. This fluid lubricates the joint cartilage and aids in movement. With osteoarthritis, the articular cartilage begins to wear away, and the synovial fluid begins to thin out. This results in the bones of the joint rubbing together without cushioning. Damaged bone may also start to grow. These resulting growths are called bone spurs.

All of the damage to the hip joint is degenerative; it gets worse over time. It also causes pain, swelling and other symptoms that get progressively more intense. Additional symptoms of osteoarthritis include tenderness around the hip, limited range of motion, a grating sensation with movement and difficulty walking.

The doctor can generally diagnose osteoarthritis through a complete history and physical exam. The doctor will confirm the findings with an x-ray of the patient’s hip.

Treatment for osteoarthritis generally begins with lifestyle modifications, such as switching from high-impact activities to lower-impact activities and losing weight. Other conservative treatments include doing physical therapy, using support such as a cane when walking and taking anti-inflammatory and/or pain medications.

If conservative treatments fail to relieve symptoms, the doctor may suggest surgery. Surgical options include hip resurfacing and total hip replacement.

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