Rehab Medicine Now in Brier Creek!

We are pleased to announce that Dr. Perico Arcedo begins today at Brier Creek, expanding our services available to patients in the Wake County area with the addition of Physical Medicine and Rehabilitation.

BrierCreek

Hip Preservation: An Emerging Approach to Hip Pain

If you are experiencing persistent or chronic hip pain, the emerging field of Hip Preservation may be able to provide answers – and get you back to your activities.  The field of Hip Preservation is a new aspect of Orthopaedics with three goals:

• To reduce hip pain

• To increase activity

• To prevent degenerative changes

Some hip conditions are misdiagnosed for an average of four or more years; with a correct diagnosis,  there are minimally invasive treatment options that not only alleviate the symptoms but reduce the risk of arthritis in the future.  Hip Preservation is a new approach to hip pain.

Michael Merz, MD, pursued a fellowship in this new field at Boston Children’s Hospital, affiliated with Harvard Medical School.  He shares that the innovation of the subspecialty drew him to Hip Preservation: “It’s really this kind of new field, and I was very excited by the possibilities of helping bring this forward and expand on this field.”  He had comprehensive training with leaders in the field in hip conditions for patients from birth through middle age that included both arthroscopy and osteotomies of the pelvis and femur.

Like all of our Orthopaedic Surgeons, Dr. Merz is trained in General Orthopaedics, and can see patients for all Orthopaedic issues.  His dual fellowship training is in Hip Preservation and Joint Replacement.  Specific conditions that he treats include: hip dysplasia (DDH), femoroacetabular impingement (FAI) or hip impingement, hip labral tears, Perthes disease, avascular necrosis (AVN) of the hip, femoral anteversion, and congenital hip dislocation.  Call (919) 220-5255 to schedule an appointment with Dr. Merz.

 

Emerge Better: Understanding Hernias in Women

When many of us hear the word “hernia” we think about a bulge that would be easy to identify.  This is a typical way that a hernia may appear in men.  But for women, hernias are much more difficult to identify, even for physicians.  Board Certified in General Surgery, Dr. Kathryn Baerman specializes in women’s health, and treats “hidden hernias” that are often misdiagnosed.

“I want to make women aware that if you have persistent groin pain, you may have a hernia that’s not appreciated that can be causing this,” says Dr. Baerman.  ”These are much harder to diagnose in women, just due to the different anatomy.”  Dr. Baerman explains that in women, hernias are not easily spotted with an MRI and are commonly misdiagnosed, being treated for  Endometriosis Pain or Chronic Pelvic Inflammatory Disease Pain. Symptoms for inguinal hernias include chronic groin and pelvic pain as well as shooting pain throughout the groin

Dr. Baerman performs procedures that can be done in clinic to aid in diagnosis and forming a treatment plan.  Treatments are usually surgical, with nerve blocks to assist with management of symptoms.  ”Once repaired, this can really improve the quality and alleviate a lot of pain and suffering for women,” says Dr. Baerman.

She shares a good article on Hidden Hernias from The New York Times.

Dr. Baerman is a General Surgeon treating patients in the greater triangle area.  With the training gained in her Surgical Oncology Research Fellowship, she specializes in benign and malignant breast disease.  Other surgical areas of expertise includes:

• Abdominal surgery – for diseases of the gallbladder, small bowel, appendix, and large bowel
• Endocrine surgery – for diseases of the adrenal, parathyroid and thyroid glands
• Hernia surgery – for inguinal, femoral, ventral/incisional, and other hernias

To see Dr. Baerman or any of our General Surgery Specialists, their direct number for scheduling is 919-281-1699.

Is Outpatient Joint Replacement An Option For You?

 

OUTPATIENT JOINT REPLACEMENT

GENERAL

If you are healthy enough, outpatient joint replacement (where you have surgery and go home on the same day) may be an option for you at EmergeOrtho.  In comparison to inpatient joint replacements, much of the process remains the same but there are a few differences.  Special consideration of the medical status of the patient is the biggest factor.  Anesthesia techniques (to make you more comfortable) are modified for outpatient replacement patients.  Physical therapy at home is begun the day after surgery.  Since you won’t be at the hospital where the surgical team can check on you, an earlier follow-up appointment is scheduled.  Lastly, you’ll need a caregiver or team of caregivers present with you to assist with walking, medications, and meals.

Some of the advantages to outpatient joint replacement include:

1) cost

2) convenience/comfort

3) fewer complications

Outpatient joint replacements often offer substantial cost savings since there is no hospital stay.  Also, they can be done at “surgery centers” which typically charge significantly lower fees than typical hospitals might.  Many patients are more comfortable being at home in a familiar environment while they recover.  Patients may be more likely to avoid complications since they are likely to move around the home more than they might at the hospital.  Lastly, the chance of picking up an infection from something or someone at the hospital is lessened the shorter the amount of time spent there.

Sometimes patients scheduled for outpatient surgery may end up having to stay at the hospital (or may be sent to a hospital from a surgery center) if unforeseen complications occur.  To lessen this risk, the patient’s health is carefully screened prior to surgery.   The bottom line is your safety is our top concern.

AT THE SURGERY CENTER

The main differences between inpatient and outpatient joint replacements at the surgery center involve the type of anesthesia used.  Outpatient patients often get a shorter-acting “block” or injection to allow them to move their legs sooner.  A long-acting “local anesthetic” to numb the tissue around the incision is frequently used to help provide comfort.  Special combinations of pain and nerve medications may be prescribed.  Generally, urinary catheters are not used for patients undergoing outpatient joint replacement.

Rather than being transferred to a hospital bed (also called “the floor”) after surgery, you will have physical therapy (PT) when recovered enough in the post-anesthesia care unit (PACU). When you have proven you can walk appropriately with PT and are felt to be safe to be sent home, you will be discharged. Patients undergoing outpatient joint replacements may stay in the PACU longer than inpatient replacement patients since they need to be fully recovered before being released.

 

RECOVERING AT HOME

  • Take your medications as directed in your discharge paperwork
  • Your leg muscles may be weak for the first day or so – make sure to wear any braces sent home with you and use your walker or crutches when you move around
    • Do not stop using braces until you are advised to do so by your therapist or surgical team
    • Try to drink plenty of fluids and eat a healthy diet – you need energy to heal
    • Follow the instructions for your dressings and showering given to you at the time of discharge

 

To learn about whether outpatient joint replacement surgery would be a good fit for you, visit www.triangleortho.com or call (919) 220-5255 to schedule an appointment with one of our surgeons.

 

Article By: William Silver, MD, Orthopaedic Surgeon, Medical Director, EmergeOrtho Triangle Division