Sea Crest Health Care Center

by Adele Weber

If it’s topical, the theory goes, it has fewer side effects than pills. Right?

Wrong.

Often overlooked, the side-effects of topical creams is more important than credited. Lidocaine is a topical numbing agent frequently used before mammograms. The cream is spread on the skin and allowed to absorb for 45 minutes. It is also used to dull pain from laser hair removal, or any other surgery covering a large amount of skin. Research studies found no side-effects; however, the clinical trial did not have enough of a sample size to account for rare and unusual side effects.

This became apparent when two women spread lidocaine and tetracaine on their legs, covered it in plastic, and left it for 45 minutes. They experiences seizures, fell into comas, and died.

Experts theorize that broken skin or elevated temperature might have raised the amount of the drug entering the bloodstream to toxic levels.

When using topical analgesic, use the minimum amount, and avoid broken skin.

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.

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.

by Ruth Folger Weiss

Few appreciate the impact of marketing on their lives, relegating it to lightweights and thinking of it as “Madison Avenue for the gullible.” But when marketing, science, and your health are in the crosshairs, it is indeed illuminating, and in my position as an advertising champion, somewhat gratifying.Pat Farnack, in her Your Health series on WCBS Radio, has been running a feature on how to choose a surgeon, and her latest, “Your Surgeon’s Car” tickled my fancy. After suggesting that one diligently sweat the details prior selecting a surgeon, i.e by Googling a prime candidate’s name, interviewing each candidate, and specifically asking how many of these surgeries he has personally been involved in as well as what his/her success rate is in the specific surgery you are considering, she quotes Peter Moore of men’s health magazine and states that one should go to the doctor’s parking lot to check out his car.”Your surgeon’s car is a window to his soul” and his success, she says. “If your doctor’s car is a wreck inside, if there’s a dent in the bumper, you have to think twice.”Your surgeon’s car should be far superior to those of the nurses and staff pulling in and out of the lot, and in a condition comparable to the one you want to be in post-op!This flies in the face of the more conservative values we were raised on: a car is a vehicle of transportation and not social aspiration.Guess, this marketing person intuited the intrinsic merits of some of what we do professionally…