Sea Crest Health Care Center

806,000 hip and knee implants were performed in the US in 2007 – that’s double the amount done a decade earlier. However, a 2007 study demonstrates that 7% of Medicare patients who underwent a hip replacement required another replacement hip within seven and a half years.  That number, small as it sounds, translates into thousands of patients who eventually need a “do over”. A joint surgery involves risk, pain, convalescence, rehab and medical expenses; no one wants to go through that more than once if necessary.

A National Joint Replacement Registry helps reduce the rate of failed procedures by keeping a database of information that keys in surgeons to problematic implants, and provides insight as to how to avoid mess ups. According to Dr. Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn,  “Every country that has developed a registry has been able to reduce failure rates significantly.”  Sweden is one case in point.

The newly formed American Joint Replacement Registry is still in its nascent stage and has started collecting data. Its goal is to improve the quality, outcomes, and cost-effectiveness of total joint replacement (TJR) surgeries through the achievement of four objectives:

1. Establish an infrastructure and a uniform system for the collecting device information and monitoring outcomes of TJR throughout the U.S.;

2. Identify patients who may need follow-up evaluation thereby increasing patient safety;

3. Create real-time survivorship curve in order to detect poorly performing implants;

4. Establish a uniform system that can be used to define the epidemiology of TJR for outcomes research to improve the quality and outcomes of patient care.

Until we have access to solid facts from the U.S. Registry, there are some proactive steps you can take if you are in the market for a new joint.

– Go with a highly experienced surgeon in a busy hospital; don’t look for the best deal. Ask for recommendations. A 2004 study published in The Journal of Bone and Joint Surgery found that patients receiving knee replacements from doctors who performed more than 50 of the procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.

A similar trend was documented with hospital volume. Patients at hospitals that performed more than 200 knee replacements a year fared better than patients at hospitals that performed 25 or fewer.

– A joint replacement is not for everyone. Some arthritic problems are better served with medication, and surgery may be too risky for those who have uncontrolled high blood pressure or another serious chronic condition.

– Research the joint implant that your surgeon recommends. Find out how well it has performed in others and if there are known complications. Some implants are somewhat controversial and may cause tissue and bone damage; newer doesn’t necessarily mean better. If the hospital has its own registry, ask to review the data.

– Educate yourself as to what the surgery entails. The American Academy of Orthopaedic Surgeon’s patient information Web site, orthoinfo.org is very helpful.

– Prepare your recovery in advance. Arrange for the necessary support upon your return home, and make sure you have all the help you need. It is crucial not to overexert yourself during your initial healing period.

Yup, there’s actually such a title. A recent Wall Street Journal article highlighted the growth of a new genre – upscale, more palatable cuisine now offered in healthcare facilities.

The typical hospital fare such as jello, soggy sandwiches and tasteless chow that we’re all familiar with, seems to be a thing of the past.  Think Machaca Steak with Sauce and Curried Banana Pierogi. Hospitals are now competing with the likes of five-star hotels and restaurants by installing sushi stations, organic salad bars and pizza ovens.

The National Society for Healthcare Foodservice Management recently launched an annual cooking competition. “We want to show the world that health-care food is so much different. It can be creative. It can dazzle,” said Betty Perez, a society board member and a hospital food administrator in New Jersey. “We have chefs that can compete with the best of them.”

However, hospital chefs must play by different rules than their glitzy restaurant counterparts. Their creative offerings must be in tune with doctors orders, as well as nutritionists and cost-sensitive food administrators.

600 calories, 20 grams of fat, and 1,000 milligrams of sodium were the max for each contest dish and the production cost per dish could not exceed $5.

So pass the Green Apple-Jicama Slaw and enjoy your stay.

Just when you think you’ve got the healthy eating thing down right, some scientific papers come out to upend your sense of equilibrium.

While you’ve been vigilant in pursuing “healthy” options in your food purchases, you and millions of others are being “played” by the less scrupulous in the food industry.

Melinda Beck, in her comprehensive article, “The Fine Print: What’s Really in a Lot of ‘Healthy’ Foods” in the May 5th Wall St. Journal, provides far too many instances of manufacturers determination and success at fooling a well-intentioned but easily misguided public.

Chicken: Roughly one-third of the fresh chicken sold in the U.S. is “plumped” with water, salt and sometimes a seaweed extract called carrageenan that helps it retain the added water- and are allowed by The U.S. Department of Agriculture to label it “all natural” or “100% natural” because those are all natural ingredients, even though they aren’t naturally found in chicken.

The “plumped” chicken has between 200 and 400 mgs of sodium per serving, almost as much as a serving of fast-food french fries. And marketers attest to blind taste tests to underline the reality that more consumers prefer these “enhanced” versions.

Salt substitutes: Many contain potassium chloride, which can exacerbate kidney problems and interact badly with some heart and liver medications- not exactly the direction you wanted to take when looking for the alternative to salt.

Artificial Sweeteners: Many brands of Sugar-free gum, mint and candy contain sorbitol, a plant extract that isn’t completely absorbed by the body and works as a natural laxative. That’s why you often experience bloating, flatulence, stomach pains and diarrhea after consuming only one pack of gum, or sucking on a few sugar-free candies. Some diabetics and others who are sensitive to the effect, find that sugar alcohols, i.e maltitol and xylitol can raise their blood sugar.

Trans fat, Cholesterol- Free, Calories-Free: Manufacturers are allowed to “round down” their numbers when it comes to trans fat, “sugar-free,” “calorie free” and “cholesterol-free” labels….! Products labeled zero grams of trans fat can have up to 0.49 gram of fat per serving. You could still be consuming significant amounts of trans fat: if the ingredients include partially hydrogenated oil, hydrogenated oil or shortening, a product isn’t completely trans-fat free. And it may have considerable saturated fat as well. And foods that have trace calories and up to 0.49 gram of fat and carbohydrates per serving- can, yes, be labeled “free” of those properties!

Super Water: The Center for Science in the Public Interest states that drinks — with names like “defense,” “rescue,” “energy” and “endurance” — are mainly sugar water with 125 calories per bottle…

Government surveys show that most Americans aren’t deficient in many of the vitamins supplied in these drinks, and the excess gets excreted anyway. Coca-Cola Co. was sued earlier this year over claims on its Vitamin Water beverages.

Consumers had better be armed with a “HEALTHY” DOSE OF REALISM WHEN SEARCHING FOR THAT PERFECT HEALTHY FOOD.

By: Ruth Folger Weiss

My brother’s early morning email message was cryptic: “Bobbo, see Page 1 of The Wall St. Journal.” Not known for spouting endearments,and having received more than my share of ribbing for the moniker I chose when my children were delivering their’s,  I was curious to see what he was alluding to.

I still couldn’t understand why  friends and family had  seemed enormously tickled  by my creative appellation; winking at my proclivity for the ostensibly hip even when it came to my  morphing into grandparenthood.

So I indulged in what was a frisson of delight reading Anne Zimmerman’s Page 1 feature in the WSJ:
“A Grandma or Grandpa by Any Other Name is Just as Old”,  Boomers Want to Pick What Grandkids Call Them: Meet Glamma and Pap Doc

Here’s the affirmation I  needed that it wasn’t just a marketer’s need to brand myself, but a representative trend of Boomers to attempt to defy the gravitational pull of  aging and to put our imprimatur on everything related to our lives.  We’re deciding what fifty today looks like, and if that means being more physically fit and well-coiffed than anyone else in history, so be it.  We’re grateful and delighted our kids are having some more of the same, and love every moment of interaction with each amazing prodigy that is gifted our way  but we’ve  got to calibrate the perspective…and “Bobbo” is who’ve I’ve chosen to be to these wonderful children who happen to be our wonderful grandchildren.

Experts in the field of aging are not surprised that baby boomers are seeking creative ways to avoid wrinkly sounding labels. “That whole generation is reinventing old age,” says Tom Nelson, chief operating officer of AARP, formerly known as the American Association of Retired Persons.

AARP’s marketing department has had to devise new ways of talking to boomers so as not to alienate them by making them feel old. The association’s magazine was called Modern Maturity for decades and two years ago was renamed AARP The Magazine. “We have put some iconic boomers on the cover, and their take on aging and all the great work they are doing reflects how aging isn’t something that has to be dreaded,” Mr. Nelson says.

So not intentionally wishing to brand myself, this marketing executive was keenly aware that  cognitive association is deeply rooted in the names we choose and the mantles we wear.  Just didn’t realize that this Bobbo  was at the forefront of another revolution!

Touch and massage can relieve pain and improve mood in cancer patients.

A study comparing the results of touch therapy and massage therapy found that both relieved pain and improved mood, but massage was twice as effective. Furthermore, there was an increase in pain relief as treatment continued over time.

The results are important, suggesting a non-medical way for cancer patients to receive pain relief.

It’s been long known that touch has a soothing affect on the human body, but there have been few studies supporting it.

Touch therapy consists of a therapist placing their hands on specific spots on the body and applying light pressure for a few moments. The treatment comes out of the holistic healing movement and has not garnered much support among those in the medical field.

Massage therapy is more vigorous, including pressing, rolling, and finger pressure at trigger points. Though not common in the hospital, massage therapy is a commonly offered as part of a physical rehabilitation program. Now, it may become an option for patients receiving painful treatments for debilitating diseases.

Barely half the hospitals in the USA have palliative care programs.

If you aren’t sure what palliative care is, that’s part of the problem.

Palliative care is a care program that includes management of pain and other debilitating symptoms and increased communication and care coordination between physician and family. Palliative care increases the quality of life for patients with complex prognoses . . . Greater palliative care has been linked to lower death rates, fewer intensive care admissions during a patient’s final months, and lower overall expense per patient.

The statistics speak, and palliative care has been increasing around the nation, but it is still almost unavailable in many rural hospitals and the south. The trend is upward, but the problem is still widespread.

The best way to receive palliative care is via hospice care, delivered in specialized institutions, such as nursing or assisted living facilities. Such facilities are smaller, more specialized, and less hectic than hospitals, permitting them greater latitude in customizing the service their patients receive.

Palliative care utilizes a broad range of services for one goal: relieve suffering and increase quality of life. When paired with standard medical treatment, the results is a more comfortable treatment and faster recovery.

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 Jeff Noley

There are some drugs with side effects that are worse than what they treat. Or at the very least, are pretty rotten compared to the alternatives.

Avandia is one example of a drug you might want to rethink taking. Yes, diabetes is a terrible disease. But so is heart disease. And Avandia raises the chance of a heart failure by 109% compared to those taking other diabetes drugs. Exactly why hasn’t been discovered yet, but that’s not the point. Diabetics should steer clear of Avandia if they don’t want to compound their health problems. If there is no alternative to Avandia, ask your doctor about taking heart medications in conjunction with the diabetes drug to lower your risk.

Celebrex is another drug you should treat with care. It’s a pain relieve that causes pain – in the stomach, kidneys, liver, and heart. Just 400 mg of Celebrex a day have twice the risk of dying of cardiovascular disease than those who don’t. 800 mg a day tripled the risk.

Pneumonia and other respiratory tract infections are among the top-ten killers of men, but one of the medicines used to treat it can kill just as effectively. Ketek can affect the heart and damage the liver. It is far better to use one of the alternatives, such as Augmentin,  doxycycline, or Zithromax.

In general, a drug-free life is a healthy one. But if you need medication, don’t blindly accept your doctor’s prescription. Visit the library and look it up in the Physicians’ Desk Reference, and check around online for testimonials or complaints from people taking it. Always ask what the alternative is, and do a search for one yourself. There are more than 4,000 prescription medications out there; your doctor can’t be an expert on all of them. But you can – and should – be an expert on anything you’ll be putting into your system.

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.

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.