Health TO YOUR
Mid-Valley Newspapers
August 2013
A guide to wellness and healthy living in the Mid-Willamette Valley
STAT Quick reads about health topics in the news
Asthma’s toll An estimated 25.9 million Americans have asthma, according to the most recent American Lung Association report. An estimated 5 to 10 percent of those have a severe case of the lung disease, which can lead to numerous emergency room visits, lost productivity at work and even death. — Fort Worth Star-Telegram
Brain chocolate
Jerry Brooks runs in Newport Beach, Calif., on July 25. In the last twelve years, Brooks has had both knees replaced, but he still competes in triathlons. JEFF HARRIS | ORANGE COUNTY REGISTER/MCT
BACK ON TRACK New generation of implants adds mileage to worn-out knees By LANDON HALL
says patients receive different kinds of pain treatANTA ANA, ment: Gone are the days Calif. — Total knee replacement, also called arthroplasty, might be a when only general anesDenise Olson misnomer: The entire knee isn’t cut out. In fact, many of the thesia would be used, parts are kept in, including the ligaments at the edges of the danced at her leaving the patient groggy joint, the lateral and medial collateral ligaments, as well as daughter’s and out of sorts upon the patella bone and its own ligament. wedding. awakening. Also, more The procedure is commonly recommended in people whose That might care is taken to avoid cutarticular cartilage, which covers the thigh bone (femur), has not sound like ting some soft tissue been ravaged by degenerative osteoarthritis. The meniscuses, a profound accomplishinside the knee. the disc-shaped pads between the cartilage on the femur and ment, but it was a moment “Now a patient will the shinbone (tibia), can also wear over the years. she could only dream of a wake up from surgery The femur and tibia are shaved down to make way for the few months earlier. without pain,” said implant, which resurfaces the bones. “Imagine you’re essenArthritis had worn away so Caillouette, who along tially doing a retread on a tire,” said Dr. James T. Caillouette, much of the cartilage in with Gorab is a founding surgeon in chief at Hoag Orthopedic Institute in Irvine, Calif. Most implants have a metal “tray” that holds a plastic platOlson’s right knee that it partner of the Hoag instiform that stands in for the meniscus. The covering on the tute. “They don’t need IV was just bone grinding on femur is super-strong metal, and when the knee bends, the narcotic pain medicine bone. The pain had steadipieces glide on top of one another. around the clock, because ly worsened for two years, Earlier generations of the implant used titanium, but that we’re giving them little making it difficult for her metal was found to wear out too quickly, Caillouette said. doses of different things, to walk up the stairs of Newer models use cobalt-chrome, a longer-lasting alloy. The The science of pain as opposed to hitting them her home. She teaches plastics in them also are harder and more wear-resistant, says with a sledgehammer.” first grade in Irvine, and Hoag Orthopedic Caillouette’s colleague Dr. Robert S. Gorab, the chief medical Jerry Brooks of Newport Institute, which opened in it’s tough to meet the allofficer at Hoag Orthopedic Institute. Beach, Calif., got his November 2010, has day needs of 30 kids when — Landon Hall, The Orange County Register arthritic right knee become one of the you can barely rise from highest-volume orthope- replaced in 2002, and his your chair. increase to 3.5 million a can’t walk.’ Because it’s dic centers in the country. left knee in 2003. He says On April 23, she had year by 2030. not much of a life for an his X-rays show almost no total knee replacement elderly patient to be “The need for surgery is Nearly 1,500 knee replacements were perwear at all in his models, surgery. Four weeks later, trapped inside. They’re exploding,” says Dr. James formed there in 2012, a 28 called the Smith & she was back in class. On cut off from their family T. Caillouette, surgeon in percent increase over Nephew Journey. He’d had July 13, her daughter and their friends. chief at Hoag Orthopedic 2011. DePuy launched the problems with the right Lauren got married, and “They want to be back Institute in Irvine, Calif. Attune in March Denise was able to walk knee for years, and it to who they were.” Shorter hospital stays (Caillouette implanted the down the aisle. finally gave out while he and faster, less painful first one on the West Later, during the recep- Procedure evolves was competing in the recovery periods have Coast), and between that tion, when Denise and her made the operation popu- model and the others, the 2001 Ironman Triathlon in Better implants, husband, Chad, were sitlar among patients who Hawaii. 70-bed hospital should improved surgical techting together, the DJ are both older and “I feel like I’m 25,” says become an even busier played “Come Away With niques and a more inyounger than used to be Brooks, who is 72 and in place. depth understanding of Me” by Norah Jones, the the norm for such candiremarkable physical Patients are usually kept how to treat a patient’s couple’s song. He invited dates. Baby boomers are for at least one night after shape, for any age. He pain during and after sur- hitting the age at which her onto the dance floor. undergoing the procedure, doesn’t race so much She accepted. gery have helped make their knees are wearing anymore, but he still runs but the protocol for their “Just the two of us got total knee replacements out, and they’re not will25 miles a week, bikes 150 treatment has changed up and danced on the available to a wider ing to give up their active miles, and swims 5,000 to vastly over the years. floor. It was wonderful,” patient base, from lifestyles without a fight. 8,000 yards. “I’m grateful Knee surgery hurts, a said Olson, who is 54. “I younger people like Olson “I would say at least half lot, and this used to be a for the fact that I got two got to dance with my to long-suffering seniors. of my patient population gifts, so I can continue deal-breaker for many daughter and my son-inThe evolution of the is under 65,” Caillouette doing what I want to do.” patients. But Caillouette law. And the party went procedure comes at a time said. “Twenty years ago, on until the closing of surging demand: About that was not the case. But hours.” 600,000 total knee it’s not unusual for me to “A lot of the patients replacements were persee a patient in their late will come in and think formed in the United 30s or 40s with end-stage they’re too old. And States last year, and that arthritis who needs surthere’s nobody who’s too number is expected to gery. We used to be very old for the operation anymore,” says Dr. Jay R. Lieberman, head of orthopedic surgery at the University of Southern California’s Keck School of Medicine. “The major reason why we do these operations in patients in their 90s is for pain, and because patients will literally say to you, ‘I don’t want to live if I
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HOW KNEE IMPLANTS WORK
fearful of doing that, because we didn’t think the implants would last very long. Now, with the new generation of designs and materials, they look like they’re going to last a very long time, 20 to 30 years or longer.” But even the boomers’ Greatest Generation parents are getting the implants in higher numbers. Life expectancy keeps increasing, of course, but there’s also a greater awareness of how quickly health can decline if immobility leaves an elderly person homebound and isolated.
Drinking two cups of hot chocolate a day may help older people keep their brains healthy and their thinking skills sharp, according to a study published in the Aug. 7 online issue of Neurology, the medical journal of the American Academy of Neurology. The study involved 60 people with an average age of 73 who did not have dementia. The participants drank two cups of hot cocoa per day for 30 days and did not consume any other chocolate during the study. They were given tests of memory and thinking skills. They also had ultrasound tests to measure the amount of blood flow to the brain during the tests. “We’re learning more about blood flow in the brain and its effect on thinking skills,” said study author Farzaneh A. Sorond, MD, PhD, of Harvard Medical School in Boston and a member of the American Academy of Neurology. “As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer’s.“ — American Academy of Neurology
Dangerous attraction Cases involving children ingesting magnets quintupled between 2002 and 2011, with ingestion of multiple magnets generally resulting in more serious outcomes, including emergency surgery. The results of a study documenting a rise in pediatric injuries were published last week in the Annals of Emergency Medicine. “It is common for children to put things in their mouth and nose, but the risk of intestinal damage increases dramatically when multiple magnets are swallowed,” said lead study author Jonathan Silverman, of the Department of Pediatrics at the University of Washington in Seattle. “The ingestion of multiple magnets can severely damage intestinal walls to the point that some kids need surgery. The magnets in question were typically those found in kitchen gadgets or desk toys marketed to adults but irresistible to children.“ “The injuries were not restricted to small children either,” Silverman said. “There were proportionally more nasal injuries involving older children, possibly because strong, attractive magnets are being used to imitate nose, tongue, lip or cheek piercings.” — American College of Emergency Physicians
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Tuesday, August 13, 2013
To Your Health