Sea Crest Health Care Center

by Jose Sonik
The more aggressively you screen for and try to prevent osteoporosis, the lower your risk of a hip fracture is, studies show.
Hip fractures are common in the elderly, especially women, who lose essential calcium during pregnancy and menopause.
Kaiser Southern California has developed a three-step action plan that they say can reduce hip fractures by as much as 25%.
The three steps are as follows:
Bone scans: Kaiser recommends x-ray absotiometry, the best bone density test available. The tests should be taken by all women over 65, all men over 70, everyone on high dosages of medicines that leach calcium from the bones, and anyone over 50 with a history of fragility fractures. These are the high-risk populations, and a scan could catch a weakening bone before it becomes a fracture.
Education and treatment: Learning and teaching about osteoporosis helps people help themselves. The more you know about osteoporosis, the better you can protect yourself from fractures. Kaiser found that patients who understood their treatment opted for more than just drug treatment: they got home safety checks to help prevent falls. Slippery bathtubs, cords across the room, and loose rugs are all tripping hazards that can snap a fragile bone.
Fall Prevention: If you’re at risk for a fall, consider learning fall-reduction techniques, that will lower your risk for a fall. Physical therapy can improve balance and coordination, reducing the risk still further.
Kaiser ran a three-part program with 620,000 patients in Southwestern United States, and found an overall reduction of hip fractures by 35%. Why wait for them to test it in your neighborhood? Start your own three-part program today.

by Jose Sonik

Some news from the science front! Hormone replacement in women is linked to hip replacement -  and childbearing is linked to knee replacement. These two new findings come out of England where 1.3 million women were followed since 1996.
Hormone replacement therapy is quite common among post-menopausal women, particularly those at risk of osteoporosis. Estrogen prevents bone-loss, which in turn prevents osteoporosis. But it seems to have a negative affect on join strength. Notable, estrogen with progestragen was more closely correlated with hip replacement than estrogen alone or tibolone.
The second finding is more startling. It’s well known that running, excessive jumping, climbing, and carrying heavy things can damage the knees, but nobody ever thought to apply that to carrying children. Though, when you think about it, some of those babies can get quite heavy.
This finding creates one of those tight corners often created by conflicting medical advice. Exercise during pregnancy is highly recommended, but it’s important to avoid unduly stressing the knees. Here are a few recommendations:
1. Swimming. Swimming takes the weight off your legs while getting your heart rate pumping. An outdoor pool or swimming no more than once a week because of the chlorine and ammonia that can build up over indoor pools.
2. Rowing, weightlifting (from sitting position), and similar exercises are healthy and will also get you ready to start carrying around a 10 lb baby.
3. Biking on a stationary bike will support your weight while giving you great aerobic exercise.
4. Yoga is both relaxing and healthy and a good idea any day.

By Ruth Folger Weiss

A few months after undergoing routine hip replacements, a number of patients of  a well known LA orthopedic surgeon started suffering from excruciating pains. The surgeon, Dr. Lawrence Dorr, was stymied until he discovered one factor they all had in common; the same replacement joint, manufactured by Zimmer Holdings, was implanted in all of them. Several needed to have their replacement replaced in another bout of surgery. When Zimmer was first contacted about this problem, they just brushed it off. It took a year of more complaints and pressure from doctors until they pulled this device off the market. In the interim many more patients unknowingly had their joints replaced with a faulty Zimmer “Durom Cup” with crippling results.

This upsetting scenario could have been avoided, and many patients could have been spared the agony, if the U.S. would have a Joint Registry in place. A Joint Registry is a national database that tracks the well being of patients with artificial hips and knees. Countries such as Australia, Britain, Norway and Sweden have such a system in place and the benefits are numerous. Tracking the success rates of the different joints available results in the faulty ones being pulled from the market much quicker. The registry data puts pressure on manufacturers to explain why their products perform poorly and the registry alerts surgeon to stop using flawed joints.

Monitoring devices like artificial joints supposedly falls under the domain of the The Food and Drug Administration but they are often overwhelmed by the vast number of products it monitors and because doctors often do not report problems.

Nearly one million hips and knees were replaced in the U.S. alone last year, about half of the world’s total. As the world’s leader in joint replacement, the U.S. should take the initiative and be the leader in follow-up too.  So far all efforts to establish a database here have failed due to the many hurdles, financial and practical, of our fragmented and decentralized health care system, as well as a lack of support from Medicare.

By Neil Bekker

Flip flops, the standard beachwear, are now the hottest form of footwear worn throughout the long hot summer days. They may be stylish, comfortable and cool, but wearing them all the time is a recipe for foot pain.

Since they offer no arch support, heel cushioning, or shock absorption, according to the American Podiatric Medical Association (APMA) they should not be used for extensive walking or for playing sports. Wearers can suffer foot pain, tendinitis, and even sprained ankles if they trip, and are also at greater risk for stubbed toes, glass cuts, puncture wounds, or having a heavy object smash their foot due to their exposed toes.

People with diabetes should choose their footwear with care since any foot injury can become serious, even leading to amputation. They should be vigilant to have a protective covering on their toes and they should stay away from flip-flops and sandals.

Orthopedic surgeons  have treated many people who ran or jumped in flip-flops and suffered sprained ankles, fractures, and severe ligament injuries that required surgery. If you use your flip-flops to play Frisbee or backyard football you’re asking for trouble.

Insect and snake bites are another danger. Emergency room physicians on both sides of the country report seeing adults and children with snake bites to the feet while wearing flip-flops or sandals.

Flip flops are also a driving hazard. If they are loose enough to pop off your feet, you’re in trouble since they get stuck under the brake and gas pedal.

One more thing, when you do wear them – don’t forget to smear sunscreen on your exposed toes.

contributed by Anne Lacey

Falls during rehab. Slips in the shower. Accidents on the stairs. They don’t happen often, but when they do happen, you want them cared for rapidly.

The traditional care for suspected fractures – a trip to the x-ray via the emergency room – isn’t fast, efficient, or remotely painless. For the elderly or disabled, double the discomfort quotient. Even once the x-ray has been taken, there’s a delay while it develops and is read by a specialist.

Which is why long-term care, assisted living, and rehab facilities should consider a recent option: portable digital x-rays.

Portable – that means that instead of you going to the x-ray facility, the x-ray machine comes to you. Yup – the back of a van. As soon as the accident happens you call the portable x-ray service and they send someone over. No need to move patients with limited mobility and who are in pain. Keep them comfortable and rested while you wait.

Digital – that means no waiting for results. The x-ray is available immediately both for you and for the service’s experts back at the base. They’ll look at the x-ray in real time and give you their reading on the spot.