Sea Crest Health Care Center

As the Baby Boomer generation ages, there is a swelling populaton of people suffering from osteoarthritis. Arthritis pain seems to go hand in hand with insomnia, with joint pain keeping awake 60% of those with osteoarthritis

A new study, reported in the Aug. 15 issue of Journal of Clinical Sleep Medicine, finds that cognitive therapy has a beneficial effect on osteoarthritis patients and insomniacs – assisting them in their quest for a good night’s sleep.

Cognitive behavior therapy for insomnia or CBT-I,was given by an experienced clinical psychologist who taught participants cognitive restructuring techniques that helped change unrealistic beliefs and irrational fears regarding sleep or lack of it.

Handwritten sleep logs kept by participants documented their sleep patterns, and pain level was graded by the Short-Form McGill Pain Questionnaire (MPQ) and the Body Pain Subscale (SF-PAIN) question from the Medical Outcomes Study Short Form-36 Pain.

Results showed that after CBT-I treatement, patients were falling asleep faster than before, and remained sleeping approximately 37 minutes longer. CBT-I seems to be an effective tool for treatment of osteoarthritis in conjunction with other pain management techniques, and may also work well with other chronic pain conditions.

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.

Choosing a doctor for any procedure can be a difficult and frustrating task. How can you possibly gauge whether any given doctor will do a good job? While it’s difficult to know for sure, here are some tips to help you reach an educated conclusion on the best doctor for you.

You can find out about any doctor by looking him up. Yup – the state medical board has an online database of every practicing doctor, and a printed version of the database may be available in your local library. The entry for each doctor lists his education, training, certification, specialties, and any legal history involved with his practice. This research can give you a good background when choosing from a field of doctors. If you have a very specific condition or are looking for a very specific treatment, take a careful note of the specialties. A doctor may be a cardiologist, but specializes in prevention or nuclear cardiology.

Magazines, such as New York magazine have an annual supplement dedicated to rating doctors. If it’s not on the stands when you begin your search, the public library should certainly have a copy.

Hospital are another thing often rated, and you should check these carefully too. If a hospital has a reputation for excellent care in a specific area, the doctors will be working harder to uphold the reputation. While a large hospital may have better resources, the small may have doctors able to provide more personalized care. Do some research on you hospital’s reputation before settling on it.

If you’re going in for surgery, find out how experienced your doctor is in performing it. Practice makes perfect, even in surgery. And while every doctor needs practice, you probably don’t want it to be on you.

Finally, don’t forget to check for bedside manner. If the doctor doesn’t listen to your concerns or treat you patiently, you can be sure their attitude will not improve when you are under their care. Choose doctors who will treat you well and listen to you. If anything feels wrong, you want to know that you have a doctor you can trust.