- Men's Health, Women's HealthGeneral Page Tier 3BlogThe holidays are here and so are all the get-togethers, parties and delicious meals. If you suffer from heartburn, then you know indulging in holiday fatty foods and alcohol can be a trigger, even if you take over-the-counter medications for temporary relief. However, if you notice that you are experiencing indigestion-like symptoms more than twice a week, you might have something more serious. Heartburn is the most common symptom of gastroesophageal reflux disease, or GERD. GERD is a digestive disorder that affects up to one in five U.S. adults. It happens when the muscle in the esophagus called the lower esophageal sphincter (LES) opens or relaxes too often or for too long. This causes stomach contents to back up into the food pipe, causing heartburn and acid indigestion. Other symptoms of GERD include shortness of breath, difficulty swallowing, chest pain, chronic cough, sore throat, hoarseness and bad breath. Although there isn’t a specific cure for the disease, you can make some lifestyle and diet changes to help you manage your symptoms: Maintain a healthy weight. The risk and severity of GERD tend to intensify for those who have higher body weights. Losing a few pounds could make you feel better. Avoid tight-fitting clothing. Tight clothes could exert pressure on the stomach, causing stomach acid to move up towards the esophagus and resulting in acid reflux. Try wearing looser clothes that don’t compress the stomach area. Avoid trigger foods and drinks. These include fatty or fried foods, tomato sauce, alcohol, chocolate, garlic, onion and caffeine. Eat smaller meals and slow down. Smaller meals can help you reduce pressure in your stomach while eating slowly can help you identify when you’re full more quickly. By slowing down, you’re also less likely to irritate your esophagus. Wait at least three hours after eating before lying down or going to bed. Staying up a few hours before going to bed will reduce your risk of reflux. Elevate the head of your bed. This will reduce the contact of the lining of the food tube with acidic contents and help you get a good night’s sleep. Quit smoking. Do not smoke or chew tobacco. Choose water over soda. Carbonation bubbles can expand in the stomach, causing increased pressure that contributes to reflux. Avoid creamed or cheesy foods and soups. All high-fat foods can cause reflux, so skipping the dairy items can help. If untreated, GERD can lead to more serious health problems over time, including esophageal cancer. It’s important that you talk to your primary care doctor about your symptoms and find a solution that works best for you. There is not yet a cure for the disease but with lifestyle modifications and/or medications, you can manage your symptoms to improve your quality of life. If lifestyle changes and medication don’t help manage your GERD symptoms, your doctor may refer you to a surgeon. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Author Adrian Park, MD, is chair of Anne Arundel Medical Center’s Department of Surgery and an internationally recognized specialist in minimally invasive surgery. To schedule an appointment with him, call 443-481-6699. Originally published Nov. 26, 2018. Last updated Nov. 14, 2019.0
- UncategorizedGeneral Page Tier 3Blog‘Tis the season for get-togethers, parties and, of course, festive foods. Unfortunately for many, indulging in holiday fatty foods and alcohol triggers heartburn. And if you find that over-the-counter medications only provide temporary reprieve, you may be experiencing something more serious. Heartburn is the most common symptom of gastroesophageal reflux disease, or GERD. The digestive disorder affects up to one in five U.S. adults. GERD occurs when the muscle in the esophagus called the lower esophageal sphincter (LES) opens or relaxes too often or for too long. This causes stomach contents to back up into the food pipe, causing heartburn and acid indigestion. While heartburn is the most common symptom of GERD, it is not the only one. Other symptoms of GERD include shortness of breath, difficulty swallowing, chest pain, chronic cough, sore throat, hoarseness and bad breath. Here are a few things you can do to bring symptoms under control this holiday season: Eat earlier in the day. By planning your holiday gatherings earlier in the day, the stomach acid from the foods you eat have time to move out of your stomach before lying down for the night or taking a nap. Limit your alcoholic drinks. Many believe alcohol leads to reflux because it can relax the valve at the bottom of the esophagus where it meets the stomach. Limiting your drinks can help. Also, acidic mixers like orange juice or soda can cause reflux. Use smaller plates. Overeating can fill your stomach, pushing stomach fluid up toward your throat. Using a smaller plate helps you avoid overindulging. Substitute water for soda. The acid and caffeine in sodas can cause reflux, but even the carbonation can cause problems. Carbonation bubbles can expand in the stomach, causing increased pressure that contributes to reflux. Pass on deep frying your turkey, as well as frying other foods. Fried foods are the single most recognized cause of reflux due to their high fat content. Avoid creamed or cheesy foods or soups. All high-fat foods can cause reflux, so skipping the dairy items can help. Check with your doctor if you are experiencing symptoms continuously for more than two weeks even though you’re taking over-the-counter antacids. GERD is a recurrent and chronic disease. If left untreated, it can lead to more serious health conditions such as Barrett’s esophagus, an abnormal change in the cells of the lower portion of the esophagus, which can raise your risk of developing esophageal cancer. No one knows for sure why people get GERD. In some cases, a hiatal hernia may contribute. A hiatal hernia occurs when part of your stomach pushes up through your diaphragm. The diaphragm, in concert with the LES, keep acid from coming up into the esophagus, but a hiatal hernia may make it easier for the acid to come up. It’s important that you talk to your primary care doctor about your symptoms. Your doctor can provide you with treatment options that are right for you. There is not yet a cure for the disease but with lifestyle modifications and/or medications, symptoms can be managed. If lifestyle changes and medication don’t help manage your GERD symptoms, your doctor may refer you to a surgeon. Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Author Adrian Park, MD, is chair of AAMC’s Department of Surgery and an internationally recognized specialist in minimally invasive surgery. To reach him, call 443-481-6969.0
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- Men's Health, Orthopedics, Women's Health, UncategorizedGeneral Page Tier 3BlogTotal hip replacement is one of the most successful surgeries for relieving pain and increasing function if you suffer from osteoarthritis in your hip. Traditionally, hip replacements were performed through two approaches – posterior or anterolateral. Now, the anterior method is gaining popularity as the “hip” hip replacement. When you have osteoarthritis in your hip, we always begin with conservative treatments, including: anti-inflammatory medications maintaining a healthy weight physical therapy a cane in the opposite hand to off load the pressure on the joint injections But if your pain persists, it’s imperative to have a surgeon skilled in modern replacement strategies to get you back on your feet and active again. Although originally described in 1881, the direct anterior approach to hip replacement was only sporadically used until recently. Technology advances, coupled with patients’ increased desire for minimally invasive surgery and faster recovery, has the anterior hip replacement gaining in popularity. Anterior hip replacement patients are routinely walking with physical therapy within hours following the surgery. The anterior approach is a muscle-sparing procedure that exposes the hip joint with one small incision over the front of the hip. The muscles and tendons are spread apart temporarily, rather than detaching them from the hip or thigh bones, as done during the traditional hip replacement approaches. Anterior hip replacement leads to less trauma to the soft tissues and more stability following surgery. During the surgery the patient is placed on a special table, called the Hana® table, that has independent leg spars allowing us to maneuver the patient’s legs to perform the surgery through the small anterior incision. This table also allows us to use intra-operative x-rays to “fine tune” the alignment of the hip replacement components. This offers better wear properties and increased stability of the hip. We use standing x-rays taken prior to surgery and reproduce this with our intraoperative x-rays to appropriately position the hip replacement components specifically for each patient, as well as make leg lengths equal. One of the biggest differences between the anterior approach and traditional hip replacement is the freedom from “hip precautions” following the procedure. Anterior patients can position the hip anywhere they feel comfortable immediately after surgery. Muscles are not cut and the risk of dislocation is low, which enables patients to have more freedom of movement after surgery. Anterior hip replacement patients are routinely walking with physical therapy within hours following the surgery. Following a traditional hip replacement, the surgeon must give specific instructions on hip precautions to prevent dislocating the new joint. These include avoiding bending the hip and turning the foot, sleeping with a pillow between the legs for six weeks, avoiding crossing the legs and not sitting in low chairs. But, for anterior hip replacement patients these precautions are unnecessary. Many patients go home in less than 24 hours and complete outpatient physical therapy within four to six weeks. The incision is closed with absorbable sutures and skin glue, which enables you to shower immediately and not have to have sutures or staples removed. The direct anterior approach can be utilized for nearly all total hip replacements. Whether patients have osteoarthritis, rheumatoid arthritis, femoral neck fracture or advanced avascular necrosis, the anterior approach is a reliable and reproducible surgical approach. Anterior hip replacement can help you get back to the life you want to be living. Author By Justin Hoover, MD, orthopedic surgeon at AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published March 31, 2015. Last updated May 31, 2018.0
- Men's Health, Orthopedics, Women's Health, UncategorizedGeneral Page Tier 3BlogPicture your cartilage as a cushion covering all of our joints. In the knee, this cushion is a little less than a quarter inch thick and covers the entire knee joint surface. If your knee cartilage is injured, a painful divot or crater can appear on the surface. In people under 40, this is often caused by an athletic or sports injury. One treatment I have used with great success when repairing cartilage damage in younger adult patients is transplanting the patients’ own cartilage back into the damaged area, specifically known as Carticel Autologous Cartilage Implantation (ACI). You’re an ideal candidate for ACI if you: Have cartilage damage the size of a nickel or larger; Are under 40; Do not have arthritis; and Have healthy surrounding cartilage. ACI is a two-staged procedure. The first stage is a minor cartilage biopsy, where a small piece of the joint cartilage is harvested from a part of the knee that does not bear weight. The small sample—about the size of two Tic-Tacs—is sent to a special laboratory, where it is cultured and grown into several million “baby” cartilage cells. About two months following the first procedure, the surgeon opens the knee again to implant the new cells. First, the damaged cartilage is cleaned out. Then the new cells are put into place, secured with a small membrane sewn over the defective area. Within six hours the new cells cling to the damaged area and begin to grow. The new cells continue to grow, eventually filling in the damaged area in about three months. Healing takes several months, but patients should return to near pre-injury status, allowing you to return to a normal lifestyle. How do I know if I have knee cartilage damage in the first place? Cartilage damage may be identified following an acute injury or following chronic knee pain, which is pain that has re-occurred for at least two to three months. When you experience knee pain, specialists often start with conservative treatment options, including anti-inflammatory medication, rest and physical therapy, and sometimes this is enough to significantly improve the situation. When conservative measures don’t work, an MRI may be ordered. The MRI can help uncover whether there is joint surface cartilage damage and its size. What can I do if I have cartilage damage, and I’m not a candidate for ACI? If you have small damage—about the size of a dime or smaller—you may benefit from an arthroscopic microfracture technique, where tiny holes are punched into the affected area and debrided to promote cartilage healing. This requires the surrounding cartilage to be in good condition. Following this type of procedure, patients are on crutches for about six weeks. For small cartilage defects, we now have some new cartilage transplant techniques that can get you going even faster. If you’re over 40 and/or have arthritis, you may be a better candidate for a partial or full knee replacement. Talk with your orthopedic specialist to uncover how to best treat your knee pain. Author James York, MD, is an orthopedic surgeon at AAMC Orthopedics. To reach him, call 410-268-8862. Originally published March 2015. Last updated July 2018.0
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