I’ve been on a two month hiatus from writing but I’m back. Of course, I’ve still been filling the airwaves with medical shenanigans every Sunday morning on Healthy Matters (which you can hear at wccoradio.com at 7:30 Central Time). In fact, last Sunday was the first show of our 11th year broadcasting Hennepin Healthcare‘s brand of accessible, accurate, and hopefully lighthearted medical information. To all of you who listen to the show, THANK YOU!
We started 2019 by talking about Physical Therapy and what it can do for you and your painful and sore bodies. It turns out that Hennepin (my health system) has probably Minnesota’s most technologically-advanced Physical Therapy gym. That’s me in the zero-gravity harness which helps people with stroke, traumatic brain injury, or other injuries safely learn to walk again. The PT department also has a dizzying (pun intended) range of services.
Women’s prenatal, post-partum, and incontinence issues
Mobility issues, including canes, walkers, and wheelchairs
Pediatric physical therapy
And much more!
But more than machines and technology, the Physical Therapy department at Hennepin has awesome people. So to launch our 11th year, I invited two of them to help listeners navigate Physical Therapy (I’ll call it PT from now on). Joining me in studio were two Doctors of Physical Therapy, Beth Stegora and Kelly Rettman.
In this post, I’ll summarize a couple topics that we covered on the show, like how physical therapy can help people with rotator cuff injuries, knee injuries, and even women with incontinence. Read on for just a few words to get you thinking.
Hi, friends! See that sign in the picture? Those signs are all over the campus at Hennepin Healthcare. Let’s just say my co-workers have shown no mercy in teasing me about them.
But hey – we have something to celebrate! I’m super pumped to be launching “Decade with Dave” – our celebration of 10 years of our Healthy Matters broadcast!
We’re starting with a live broadcast of Healthy Matters from the atrium at Hennepin Healthcare’s Clinic and Specialty Center complete with a LIVE audience. That’s where you come in. I’m inviting you – my Healthy Matters listening friends – to be that live audience on Sunday, June 10. Denny Long will be there, I’ll be there, and I hope YOU will be there.
Here’s what we’re planning for the live broadcast of Decade with Dave . . .
Diabetes and the Sweet Life. I’ve invited an old friend from my medical training, Dr. Laura LaFave, to introduce her to Healthy Matters listeners. Dr. LaFave recently rejoined the Hennepin Healthcare faculty in Endocrinology – in fact I don’t even have a link to her picture yet! She’s a friend, a smart doctor, and a genuinely good person. She’s been practicing for over a decade but only been back to Hennepin for a few months, so to welcome her back to our family I’m putting her in front of a live audience. She’s a good friend, eh? We’ll talk about diabetes and other hormone-y topics.
Arthritis Treatment Options: Moving from Pain to Gain.Dr. Rawad Nasr is Hennepin’s Director of Rheumatology and another colleague with whom I go way back. We dragged him back from his practice in Bemidji to join our Hennepin faculty. His recent show about arthritis was a huge hit with listeners so he’s coming back to chat with me about arthritis and joint questions. You’ll love this guy.
Sleep Health: What Keeps You Up at Night. Another really popular topic – in fact, perhaps the most popular topic – is sleep. We all need it, we all want it. Many of us struggle to get the best sleep we can. Another Healthy Matters veteran, Dr. Ranji Varghese, will be at the broadcast to meet you, to help us understand sleep, and to answer a few questions.
Following the broadcast, we’ll have a bit of Q&A and show you around the place a bit. We’ll have coffee and munchies (donuts, anyone?).
After kicking off the summer with “Decade with Dave” we are launching an exciting new health education program for the curious and inquisitive among you. “Here 4 Health” is a series of three educational sessions on a variety of health topics sort of like a mini Medical School. Except more fun. And not nearly as grueling. Come to learn about health topics from cool experts from Hennepin.
You can attend 1, 2, or all 3 sessions. They’re all free of charge, but you do need to send your RSVP by clicking here. All events are at the Hennepin Healthcare Clinic and Specialty Center.
Here’s what we have planned for “Here 4 Health” (subject to change if any of these colleagues chicken out):
Session 1: Thursday, July 12, 5-7 p.m
How to live to 100 or die trying. Dr. David Hilden (that’s me) will be updating a popular session I’ve been giving for years. I’ll take you behind the scenes at a state-of-the-art working clinic with insider tips on staying healthy.
The Ins and Outs of GI Health. OK, some smart aleck (probably the same guy who decided to make a career of doing colonoscopies) made up the name for this informative session about colon cancer. Learn from Hennepin gastroenterologist Dr. Jake Matlock about colon cancer and colonoscopies! I know Jake. Great guy. Ask him to show you a colonoscope. Then ask him why the heck he thought it would be cool to look at people’s intestines all day. You’ll also get the special chance to tour a colonoscopy suite – when you’re NOT on the cart getting your own colonoscopy
Session 2: Saturday, August 11, 9-11 a.m
Dermatology – your skin questions answered. Hennepin dermatologists Dr. Sara Hylwa and Dr. Jenny Liu will be on hand. You’ll never get a better chance to tap into a skin doctor’s expertise. They are smart and they know skin like the back of your hand – literally. Just don’t ask them if you can skip wearing sunscreen. (Spoiler alert. . . you can’t . . these two are so stingy on that point).
The Ancient Art and Modern Practices of Integrative Medicine – Acupuncture and Chiropractic. A certified acupuncturist and chiropractor will show you around the world of integrative medicine. Maybe you’ll come away just a little less mystified at these ancient practices. Ask to see an acupuncture needle. Dr. Richard Printon and acupuncturist Jessica Brown will be on hand!
Session 3: Saturday, September 15, 9-11 a.m.
You Gotta Have Heart. Recent Healthy Matters guest and cardiologist Dr. Michelle Carlson will show you around the world of heart health. You’ll learn from her particular expertise in women’s heart health and the link between heart health and cancer. You may want to check out the recent post I did with Dr. Carlson here.
Best Practices in Breast Health. Leah Hahn is the supervisor of the mammography program at Hennepin. See a mammogram machine for yourself. Men, you too should attend this session. It will give you a new appreciation for the women in your life. And men get breast cancer too! Check out this post I did with Leah Hahn from a few months ago.
A Little Help for your Friends. Hennepin has the best Physical Therapists AND therapy facilities in the region. Come see a PT gym and look at the amazing possibilities for therapy. This is state-of-the-art stuff which you can learn from Senior Physical Therapist Beth Stegora.
Attend all three sessions or pick and choose the ones you want. They’re all free and all at the Hennepin Healthcare Clinic and Specialty Center in downtown Minneapolis Probably the most important part of all . . . the parking is right there underground. Could not be simpler.
Why should I go learn something?
Here’s why I think you should attend the LIVE Decade with Dave broadcast and why you should attend the Here 4 Health series . . .
You could sit home and watch TV. Or stare at the grass and watch it grow. Or sit on your couch and get bad health information from the Internet.
Or you could get out of the house, come to the Here 4 Health series, and learn from fun, smart, and reliable doctors and health professionals. All while taking in the art-filled and warm setting of a state-of-the-art health facility.
Hey, what were you doing on Sunday morning, December 3? I know what I was doing – I was on the air with my colleague Dr. Rawad Nasr – and we were talking about arthritis. Dr. Nasr is a rheumatologist and the hour on the air just flew by. We had so many questions that we only got to a small fraction of them.
I guess you all want to learn about arthritis!
I’ve been promising to do a post with Dr. Nasr’s answers to some of the questions we didn’t get to that morning. I asked him to give written answers to listener questions, and he has begun that huge task, so the first batch of questions is here!
I do invite you to listen to the actual audio of the radio broadcasts, which are conveniently available as podcasts, without commercial breaks, for you to listen to on your computer or mobile device. To do that, click this logo to reach the main podcast page, then select Healthy Matters show #465, December 3, 2017.
Back in April I posted about medical science and what I had learned at my latest continuing education conference (the American College of Physicians conference in San Diego). Go ahead and re-read that post to get my thoughts on how to approach medical science. I had said that I’d be doing future posts about some of what I learned at doctor school in San Diego. The first of those was a look at Clostridium difficile (C. diff) infections. Now I’m tackling Lyme disease, much at my own peril since there is raging controversy about this one – at least with some folks.
Here’s what you’ll find if you read on:
Lyme disease basics.
Acute Lyme disease.
Post Lyme Disease Syndrome, which some call “chronic Lyme disease.”
Last week was an “Open Lines’ show and thanks to the best listening audience in the world, I had more questions than I had time for answers. Here’s another edition of Quick Tips from the listener mail bag.
If you missed the show, click the Healthy Matters logo below and listen to it on your time, your terms, your device. I’m all accommodating like that.
I’ll cover heart valves, uterus prolapse, and gout – all questions from listeners. Remember these are quick tips only so not complete answers. It occurred to me that none of these topics are in area of expertise so I’ll be very general. As always, my medical thoughts are only for advice and information. You should see your own doctor for your own personal needs. Continue reading “Quick tips: Heart valves, prolapsed uterus, gout”→
A few months ago I launched the first in what I hope will become a recurring series: Pearls from Medical Science. As many of you know, I strive to provide high-quality, scientifically accurate medical information on Healthy Matters, both the radio show and this blog. As do most doctors, I get inundated with medical journals, which are the repository of what the medical science community has learned about our various medical conditions. Since nobody can read all this (or want to), every now and then I will present one thing I’ve learned from what doctors call (with apologies to Hemingway and Fitzgerald), the “literature.”
Time for a topic from the Healthy Matters mailbag. Today’s “Open Lines” show was a busy one, and as is the case for these shows, I leave many questions from listeners unanswered, or not fully answered. Mea culpa, Healthy Matters listeners! Miss the show today? You can always listen to the podcast at your leisure – in your pajamas, in the car, while out exercising. Anywhere you want. You’re so connected like that.
I’ve picked just one of today’s queries to highlight here.
Injecting goo into your knee
Here’s a text from today’s show (paraphrased a bit):
“I recently had injections of hyaluronic acid over 3 weeks. Now I’m having severe pains in knee and calf when walking. . . taking ibuprofen and resting and ice-packing . . . “
I can relate to this question since I’m no stranger to bone and knee pain. Witness the body work I needed after a marathon a few years back. I think I may actually be unconscious in this picture:
Alas, injections of hyaluronic acid or steroids or fairy dust or salt water or anything else aren’t going to help me. None of that is probably going to help the person who asked this question, either.
First, some definitions:
Osteoarthritis (OA) is the very common “wear-and-tear” type of joint disease (not to be confused with inflammatory joint problems, of which rheumatoid arthritis is the most familiar one). In OA, the cushioning cartilage wears down over time, leading to pain with movement of the joint.
(Don’t get me wrong, my problem in the picture above is not osteoarthritis. My problem is entirely self-inflicted but I’m going for the sympathy vote here).
Hyaluronic acid (HA) is the naturally occurring goo in your joints, which helps to lubricate the moving parts. Viscosupplementation is the practice of injecting a manufactured version of hyaluronic acid into the painful joint. By the way, viscosupplementation, although the proper medical term, doesn’t sound nearly as cool asinjecting goo, so I’m going with the latter term.
Some brands of injectable hyaluronic acids are made from bacteria, I think.
Other brands are made from rooster comb. Seriously. I’m not making that up. You are literally injecting chicken parts into your body with some of them.
So does it work?
In a word, no.
It has long been proposed that injecting a manufactured form of HA will aid in the pain of osteoarthritis. It does make some sense, I think. After all, lubrication is good for the pistons in my Mini Cooper. It worked for the Tin Man as well. And people have been trying it for years. A lot of years. To be fair, many people do seem to report some relief from it. If it is going to work at all, the relief should be expected to be delayed (a few weeks after the injection) but may last for many months. And you can find some fairly respectable Internet sites that discuss it as a viable therapy.
“We cannot recommend using hyaluronic acid for patients with symptomatic osteoarthritis of the knee. Strength of Recommendation: Strong“
You can read the whole guideline by clicking the link above – it is not exactly a page-turner but it is thorough and covers everything you want to know about knee arthritis. You can believe these guys from AAOS. The little teensy-weensy clinical benefit that may or may not be present from these injections just isn’t to be found. May as well inject sugar water as best we can tell.
So what does work for osteoarthritis?
A whole lot of us, doctors and patients alike, wish we had a cure, or just better treatments, for the many people who have joint pain. What we do have that has some scientific basis is what you might expect:
Strengthening and exercise program to build up the support structures of the joint.
Weight loss if overweight (BMI 25 or greater).
Use NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen and naproxen.
So for our texter who raised the question, you raise a really good topic and I hope you get some relief! Here’s my thoughts:
First, make sure you have tried a good course of physical exercise, including strengthening exercises.
Second, unless you have a contraindication to using them (and there are many – like heart failure, intestinal ulcers, kidney disease to name a few), then give the NSAIDS a try for a while.
Maybe not surprisingly, acetaminophen (trade name Tylenol) has not been shown to help much.
If your osteoarthritis is only mild to moderate (not severe), and you have received relief from the hyaluronic acid injections, then it may be something to consider for you (it does carry FDA-approval for what that is worth), but there is no evidence to support it and so I don’t recommend it for my patients.
If your pain is severe, see an Orthopaedic Surgeon. Knee replacement does work for many people.
What about the symptoms the texter is experiencing – the calf and knee pain? Well that could well be a side-effect of the injection itself. Nothing is risk-free, including these injections. Could be an infected knee (a serious problem which requires attention) or a fluid-collection or something else. I recommend going in for evaluation to rule these things out. I suggest an Orthopedic specialist or a Rheumatologist for that.
Thanks for listening to HealthyMatters and for checking out the blog!
Next week on the radio broadcast: Diabetes – the latest research on controlling your blood sugars.