Posts made in December, 2012

Black Men and Prostate Cancer

There’s no need for African American men to fear prostate cancer, says urologist Dieter Bruno, M.D.

“But they should be proactive and educated about it, because it is a serious health risk. We know that African American men tend to have prostate cancer more aggressively, but we don’t know why,” he says.

Dr. Bruno suggests that men start screening for prostate cancer at age 40, especially if they have a family history of the disease. Early detection is key, because symptoms only appear in men with advanced stage prostate cancer, which is less curable, he says. Men may tend to avoid screenings for prostate cancer because they fear the discomfort, but Dr. Bruno emphasized that the minimal amount of discomfort is well worth the potentially life-saving information. Learn more about the latest tests and treatments for prostate cancer in this video from Bounce TV.

Chemical Dependency and Aging

Most people look forward to the golden years, but after age 75 many medical issues arise that can compromise quality of life, says Mike Menefee, Ph.D., director of Outpatient Services at Mills-Peninsula’s Behavioral Health Services Center. “Joint and back pain is especially prevalent among seniors,” he says. In fact, the National Institutes of Health report about half of older Americans living on their own have chronic pain. To manage this pain, many older Americans use opiates, Dr. Menefee says. “Taken over time, they can develop a tolerance for the medication, so either their dosage has to increase or they have to stop taking the medication, go through withdrawal and start a new opiate.”

 Dependency vs. Addiction

While developing a tolerance for a pain medication is concerning, Dr. Menefee draws a distinction between being chemically dependent on a medication and addictive behavior. “Many people become dependent on opiate medication, but if they take the medication as prescribed, it’s not a problem,” says Dr. Menefee. According to Dr. Menefee, patients who have developed an addiction don’t adhere to a prescription. They take more medication to relax or ease anxiety.

Risk Factors for Addiction

Many facets of life for older Americans make them vulnerable to addiction:

  • Isolation: A senior may lose a spouse or close friend, or retire. He or she becomes increasingly isolated. According to Dr. Menefee, this lack of social structures or organized activities leaves people feeling isolated and lonely. ”Living alone and not meeting daily challenges is fertile ground for anxiety disorders,” he says. “Dealing with the world every day eases anxiety. Seeing the world through the TV, people become fearful about whether they can cope.”
  • Deterioration of physical function: As people age, their livers don’t process alcohol as they once did. So the same two drinks someone has throughout their lives become too much in their 70s and 80s. “Drinking too much puts older adults at risk for falling,” says Dr. Menefee.

Danger Signs for Substance Abuse

Mike Menefee, Ph.D.

If a family member suspects that a loved one may be abusing drugs or alcohol, what are the warning signs?

  • • Falls and unexplained bruises
  • • Poor grooming
  • • Poor eating
  • • Using multiple pharmacies (“This is a common way to shop for drugs,” Dr. Menefee says. “It is also harder to monitor on the Internet.”)

Helping Seniors Help Themselves

Finding a way to overcome the social isolation associated with aging is paramount to recovery for older Americans. For many, learning to use the Internet and having access to email can help ease social isolation, as does getting involved in activities. “Seniors can keep some contact with the world through email. They can communicate with grandkids and friends,” said Dr. Menefee. “But we want them to exercise, go to senior centers or walk with friends, too.” Mills-Peninsula also offers senior behavioral health services to help manage depression and recover from substance abuse. The program meets two to four days per week for four hours, with lunch provided. “Sometimes we help people move from the home they used to share with family to senior housing or assisted living,” says Dr. Menefee. “We reconnect them to volunteer services and senior centers, and we help them form new bonds with peers. It’s been very successful for a lot of seniors.” For more information on Mills-Peninsula’s senior behavioral health services, call 650.696.4666.

Shortcut to Recovery

Arthroscopic Surgery Helps Athletes Get Back in the Game

“My primary goal is to allow my patients to return to the sports they love as quickly and safely as possible,” says Mills-Peninsula orthopedic surgeon Dirk Diefendorf, M.D.

One of Dr. Diefendorf’s primary tools is the art of arthroscopic surgery – a minimally invasive surgical technique that allows surgeons to examine and repair damaged joints through minute incisions. This is a huge advantage over traditional open surgery because the joint does not have to be opened up fully. This reduces recovery time and increases the odds of surgical success due to less trauma to the connective tissue.

Smaller Is Better

“A vital instrument for the procedure is called an arthroscope,” says Dr. Diefendorf, holding up a thin metal shaft, smaller than the circumference of a pencil. A slim metal tube, just slightly larger than the arthroscope, is inserted into tiny incisions or “ports” in the patient, he explains. Knee repairs typically require two ports; shoulders require three to four. But each port is no more than two to three millimeters wide, leaving tiny scars so fine that, six months later, few patients even notice them. The arthroscope, which includes a miniature camera and a light source, is inserted into the tube and moved from port to port as needed throughout the procedure. Images from the camera are then transmitted to large video monitors located throughout the operating room. These screens enable the surgeon and his or her team to visualize and manipulate the joint and make repairs by guiding their instruments entirely by watching the screens. Joints that are most commonly repaired with this form of minimally invasive surgery include the knee, shoulder, elbow, wrist, ankle, foot and hip. Arthroscopic procedures are often used to treat a variety of orthopedic conditions. Some of these include:

  • Torn floating or surface cartilage
  • Torn rotator cuff s (shoulder)
  • Labral (shoulder) and instability reconstructions
  • Reconstruction of ligaments (such as the anterior cruciate ligament, or ACL, in the knee)
  • Trimming of damaged cartilage such as a torn meniscus (specialized cartilage also located in the knee joint)

Giant Leap Forward

“Arthroscopic surgery has allowed those of us practicing sports medicine to greatly improve our effectiveness and efficiency in treating these types of injuries, enabling athletes to return to their previous skill level,” says Dr. Diefendorf. In previous years, he says, operations that would take four hours can now be done in one to two hours, which also means the patient requires less anesthesia. “Most people go home the same day as their operation,” he says. “Best of all, the person experiences less pain and the post-operative recovery period is significantly shorter,” Dr. Diefendorf continues. “This greatly increases an athlete’s ability to get back on the field, the course or the court as quickly as possible.”

It’s the Season for Emergency Preparedness!

If you’re a friend or family member of Mills-Peninsula emergency preparedness coordinator Deborah Tauscher, you may find emergency granola bars, a flashlight, whistle or museum putty to secure TVs and bookcases in your stocking.

“These may not seem like traditional holiday offerings but gifts to help your loved ones prepare for emergencies and disasters can be much appreciated,” says Tauscher. “This year instead of getting another tie for dad or sweater for mom – theme your gifts around emergency preparedness to show how much you care.”

Here’s a list of top gift items that will help keep your loved ones safe if disaster strikes:

  • LED flashlight: choose the gift of bright light to replace those ancient flashlights that dim when you turn them on.
  • Well-stocked first aid kit: to replace the old one with expired items and missing supplies.
  • Sleeping bag, camping gear and roadside emergency kits: these gifts have many other uses but are also emergency and safety preparedness essentials.
  • Your gift of time: offer to help a family member scan cherished photos and other important documents onto a thumb drive that can be stored in the family disaster kit.

“If you are at a loss as to what to get for family or friends this holiday season, you don’t need to be,” says Tauscher. “Give the gift of emergency preparedness wrapped up with a bow!”

For more preparedness tips, see our monthly series of blog posts on disaster preparedness.

Return to Activity, Health with Total Joint Replacement

Total joint replacement isn’t just about relieving pain in a joint,” says orthopedic surgeon, Paul Hazelrig, M.D. “It’s about getting a person back to living a normal, healthy life.” Over time, joint surfaces can be damaged through injury, old age, trauma or disease, he explains. The most common cause of joint failure is osteoarthritis, a degenerative disorder affecting close to 21 million people in the United States in which cartilage deteriorates, causing injury to the joint. People feel stiffness, pain and loss of movement as bone starts to rub against bone, most often in the knees and hips.

Making Connections

Total joint replacement is a procedure that replaces damaged joint surfaces with man-made materials. In a knee replacement, for example, the tops of the femur and tibia are each replaced with a metal cap. A piece of plastic is then inserted in between the two, along with a plastic component across the top of the kneecap. This allows the kneecap to slide easily, pain-free, against the femur. Dr. Hazelrig describes the procedure in this video segment from Healthpoint TV.

A Permanent Solution

“The results are remarkable,” says Dr. Hazelrig. “Patients go from a disabled state to a state of normal activity in as little as three months. For most people, their new joints last a lifetime. The failure rate for a total knee replacement is one-half of one percent per year. That means if a person lives for 20 years after his surgery, there’s a 90 percent chance that the replacement will last for the rest of his life.”

Amazing Advancements

When he first started doing joint replacements more than three decades ago, Dr. Hazelrig recalls anchoring the components to the bone with cement. That changed 25 years ago as orthopedic surgeons began implanting joint components using a special carpentry technique. This allows them to shape and customize the materials to fit so perfectly into the bone it does not loosen over time and no cement is required.

“We’ve also seen incredible improvements in materials,” says Dr. Hazelrig, adding that cobalt-chrome alloy and ceramic joint bearings have replaced simple polyethylene bearings. “Minimally invasive surgical techniques are another significant advancement, allowing us to do smaller incisions than ever before,” he continues. “This helps the patient recover faster and leave the hospital quicker.” On average, patients are hospitalized for two to three days for a total joint replacement, followed by six or more weeks of physical therapy.

New Limbs, New Life

Dr. Hazelrig recommends the procedure for anyone who has a damaged joint that is beyond repair and does not respond to other treatments. “The majority of my patients are elderly, but many are younger people, too, who have injured their joints in sporting activities or because they are overweight,” he says. “Recovering mobility is also key to getting back to good cardiovascular health and, in general, regaining a brighter outlook on life.”