Dr. Dollinger: Osteoarthritis

Many claim that their joints can predict a change in the weather. Often, this could be due to joint sensitivity caused by osteoarthritis. Osteoarthritis: “osteo-” means “bone,” “arth-” means “joint,” and “-itis” means “inflammation.” Osteoarthritis is a degenerative disease that usually comes with age. The unfortunate part about osteoarthritis is that doctors and scientists do not fully understand what actually causes it. What they do know is that cartilage is a very specific type of tissue in your body, so once it is gone, there is no making more of it.

When cartilage is healthy, it is nice and smooth, cushioning the bones that form the joint. Together with the synovium (an envelope that surrounds the joint), they cut down on friction and lubricate the joint. When the cartilage and synovium are not nice and smooth, there are typically two causes: normal aging or injury. In either case, the cartilage no longer properly does its job, which causes the joint to not move correctly, which puts stress on the bones, which causes inflammation and the synovium creates more fluid, which causes swelling. Whew! Joints like the hips, knees, spine, and ankles are particularly vulnerable to wear and tear. This results in joint weakness, stiffness (especially when you first wake up and after sitting for a long length of time), crunching, and grating (especially when walking up stairs).

So how do we treat it? Well, I like to keep it simple and start with medication. This could be an over-the-counter anti-inflammatory, like ibuprofen or Aleve, or a prescription for something stronger. These medications tend to work pretty well, but, like all drugs, they also have side effects, such as increased blood pressure, stomach ulcers, and strain on the kidneys.

In addition to anti-inflammatories, there are cortisone injections, which also work fairly well, and are administered every six months or so. One of the newer treatments are hyaluronic acid injections, which work in the same way as the synovial fluid, producing exciting results for many people. The catch is, however, that the FDA has approved these injections only for the knee. Of course, traditional splints, canes, and walkers can provide support and relief from certain symptoms, as well. Lastly, surgery, either to fuse the joint or to replace the joint, may ultimately be needed to ease the symptoms of osteoarthritis.

The most important principle is: if you continue to use your joints, you stand a better chance of not losing them too early on in life. So, if you find that you are getting too good at predicting impending thunderstorms, it might be time to talk to your doctor about what could work best for you in order to preserve your joint function and keep you on the move!

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.

Auxiliary Sponsors Southern Charm Tour

This year, the Arnot Ogden Medical Center Auxiliary is sponsoring an exciting 7-day Southern Charm vacation tour in October. See full details and rates by following this link. Our special of $100 off expires tomorrow, Friday, April 5. So, act fast and book now!

The tour begins in beautiful antebellum Charleston, South Carolina, where magnificent formal gardens grace much of the historic district. Enjoy a guided tour of the city highlighting the cobblestoned streets, historic homes and restored buildings, some with origins prior to the Revolution. Stop at the battery overlooking Fort Sumter where, on April 12, 1861, the first shots of the Civil War were fired. Experience southern plantation living as you explore one of America’s oldest working plantations, Boone Hall, set amidst moss draped oaks.

Travel south along the coast through South Carolina’s Low Country to the charming town of Beaufort, the “Queen of the Carolina Sea Islands.” Perhaps you’ll opt to explore Beaufort’s charms in a horse-drawn buggy or stroll around the streets at your own pace. Then, the tour continues in historic Savannah, home of the largest National Historic Landmark district in the United States. Spend the afternoon wandering this enchanting city’s tree-filled squares, the City Market or the River Street shops.

Next, a tram brings you on a tour of the Jekyll Island Historic Landmark District – one of the nation’s largest restoration projects. The Rockefellers, Vanderbilts and J.P. Morgan once vacationed here along the 240-acre river edge. Visit another of the fabled Golden Isles, quaint St. Simons Island. See its striking 106′ tall lighthouse and visit the Museum of Coastal History.

Then, travel south to the United States’ oldest city, St. Augustine, first settled in 1565. Upon arrival, enjoy a guided trolley tour highlighting the Old Spanish Quarter, historic Bayfront, “Old Town,” which dates to 1572, and the Plaza de la Constitucion with its shops and restaurants. Lastly, return to Jacksonville and join your fellow travelers for a farewell dinner.

If you miss the early booking special, there’s still time to make reservations at regular prices. Find out more by following this link. To book your reservation, contact Sue Van Sickle at (607) 737-4267 or svansickle@aomc.org.

Dr. Dollinger: Shin Splints

With warmer weather finally appearing, these first few weeks of spring have people giddy to get outside and get active again. For many runners, the temptation is to go from 0 to 60 much too quickly after being fairly inactive for the winter. For many, this leads to an increase in cases of annoying and painful shin splints.

Shin splints are simply a stress problem: the muscles and tendons along the inside of the tibia bone in your shin become inflamed, which also causes the periosteum (a membrane that lines the outside of the bone) to become inflamed, which can be fairly painful, since there are a lot of nerve endings in the periosteum. This pain can be sharp or dull and can occur during or after physical activity. Chronic shin splints can actually cause stress fractures in the tibia. Even worse, continued exercise beyond safe limits can lead to chronic exertional compartment syndrome, which may require surgery. Clearly, shin splints need to be taken seriously.

Immediate treatment of shin splints includes taking ibuprofen or aspirin, rest, and ice for 20 minutes. In addition to short-term treatment, it is best to avoid being overly ambitious and to go back to your physical activity very slowly and gradually. Adding in lower impact activities such as swimming or cycling, or cross-training can help you achieve a higher level of activity more quickly with a lower risk of shin splints.

So, if you have been cooped up inside for the last four months and then decide to go for a 5-mile run, you risk getting shin splints. If you usually run flat routes and suddenly change to hilly routes, you are at risk. If you have either flat feet or very high arches, you are at risk. And please do not run barefoot. Although many claim it is more natural for a human to run barefoot, most of us go running on man-made surfaces, like roads and sidewalks, where there may be debris or broken glass. These surfaces are much too hard and have too much impact on bare feet, as opposed to a dirt ground or grassy meadow. Besides, most of us have been wearing shoes from a very young age, so our feet are more adapted to shoes at this point in our lives.

Thankfully, it is relatively easy to keep shin splints at bay. Always warm up and stretch before and after exercise. Be sure to buy the right kind of shoe for your activity and replace your shoes regularly, before the support is worn out. If you are at a high level of exercise, have two pairs of shoes, alternating between them. If you have flat feet or high arches, wear orthotics. Lastly, slowly and gradually increase the length of time and extent of your exercise. It’s better to run for only a modest amount at first, as opposed to running too much and finding yourself right back on the couch, which is the last place you would want to be for these first weeks of spring.

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.

Getting Enough Vitamin D

By now, we are all completely fed up with this Upstate New York winter that seemingly will never end. Even on a sunny day, it’s still too chilly to soak up that sunshine outside. That being said, it’s important to talk about getting enough vitamin D.

Why do you need vitamin D?

It has an important role, which is to help absorb the calcium that you get from your diet. This is especially true in children’s development, because children with vitamin D deficiency develop weak and misshapen bones, commonly called rickets. Vitamin D and calcium levels are also important later in life in the prevention of osteoporosis. Newer studies are also starting to show that vitamin D may also help protect you from colon, prostate and breast cancers [Source: National Institute of Health].

How can you get vitamin D?

Usually, when your skin is exposed to sunlight (specifically, ultraviolet UVB radiation), a series of reactions take place, producing vitamin D3. Some studies show that “approximately 5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D,” [Source: National Institute of Health]. However, given the increasing risk of skin cancer, always be sure to take appropriate precautions to limit exposure to harmful UV rays, no matter the season. So, you still may want to consider alternate sources of vitamin D.

You can also get vitamin D in certain foods that you eat, such as cod liver oil, fish, eggs, mushrooms, as well as foods that are fortified with vitamin D like milk, tofu, orange juice, and cereals. Vitamin D also exists in various supplements, many in combination with calcium. However, be sure to talk to your doctor to check for any possible interactions with medications that you are taking before you start taking vitamin D.

As we all do what we can to fight cabin fever as we impatiently wait for spring to arrive, it’s good to remember to keep our vitamin D levels up.

Poison Prevention Week – Meet Twitch & Twiggle

Twitch and Twiggle

Twitch and Twiggle help teach children to be safe and to think, “If you don’t know what it is, STAY AWAY and ask a grown-up.”

The Arnot Odgen Medical Center Auxiliary has been working to keep children safe from accidental poisoning since 1972, when the Emergency Department asked volunteers to present a program in the schools. In the beginning, children were taught to work with parents to put stickers on dangerous products, but by 1998, the regional poison center was advocating a very different approach. Because stickers fall off or may not be applied as products are replaced or may not be used at relatives’ homes, a new program was developed to teach children to think: “If you don’t know what it is, STAY AWAY and ask a grown-up.

This new focus required creation of new, original scripts, visuals, and handouts, and three new “partners” joined the team: puppet bunnies named Twitch and Twiggle and a squirrel named Flibberty Jibbet. In Book One, Twitch gets in trouble with grandpa’s medicine. Children discover how much candy and medicine look alike, in shape, in color, and sometimes in taste. In Book Two, Flibberty Jibbet joins in, and they explore dangers outdoors and in daddy’s garage.

Their actions provide “teachable moments,” which are creatively presented to young children by volunteers who are experienced, retired elementary school teachers. These dedicated volunteers presented this valuable 30-minute program to over 4700 children in 66 schools last year alone. Schools include every public and most parochial schools in Chemung, Steuben, Schuyler, Tioga Counties and in northern Pennsylvania, as well as Head Start classes and nursery schools throughout the area.

The goals of the program are:

  • To inform young children about the dangers of common substances found in their daily environment.
  • To heighten a child’s awareness about unsafe products and practices in an entertaining way, with a “story time” format and a kit which helps demonstrate how products can look alike, but one may be safe and the other, dangerous.
  • To teach each child to think for themselves: “If you don’t know what it is, STAY AWAY from it and ask a grown-up what it is before touching it. Something may look pretty, feel good, taste good, smell good, but it still could be poison.
  • To encourage dialogue between parents and children and to educate both parents and teachers about poison prevention tips.
  • To reinforce the 911 emergency phone number.
  • To publicize the National Poison Emergency Number, 1-800-222-1222, which connects the caller to the nearest regional poison center.

We salute our volunteer presenters, who are instrumental in keeping children safe! They are: Beverly Evans, Sue Fahnestock, Maureen Gladke, Ellen Hicks, Linda Murelle, Debby Perry, Nan Wyak, and Marge MacPherson (Mrs. Mac), chairperson.

Coming Up: Poison Prevention Week

Next week (March 16 – 22) is National Poison Prevention Week, and ArnotHealth prides itself on taking a proactive stance in educating both children and their parents on how to keep accidents from happening.

Did you know:

  • 94% of all poisonings happen in the home.
  • 51% of calls to poison centers involve children 5 years of age and younger.
  • Most poisoning accidents involve common household products, such as: medicines, cleaning products, cosmetics, plants, pesticides, craft and office supplies, and tobacco products.
  • Last year, 6000 children under 5 years of age ingested laundry detergent “pods.” More than half were treated in emergency departments for symptoms such as vomiting, oral burns, respiratory distress, etc., and one child died. (Source: www.upstatepoison.org; Poison Prevention Newsletter, Sept. 2013)
  • Studies show that adults are using more medications. So, calls to poison centers about children accidentally ingesting medicine have also been increasing steadily.

The Upstate Poison Center offers these Poison Prevention Tips:

  • Keep all household chemical products and medicines out of reach and out of sight of children.
  • Store medicines and household products separately and NEVER with food products.
  • Keep items in the bottle, box, or jar that they came in.
  • Use safety packaging properly.
  • Be sure to close containers tightly after use.
  • Leave labels on all products, and read labels before using.
  • Refer to medicine as “medicine” and not “candy.”

Wherever you are in the continental United States, one number will reach the nearest poison center, 365 days a year, 24 hours a day: 1-800-222-1222. The Upstate New York Poison Center is also a great source of support and information. Click here to download their poison safety checklist.


Dr. Dollinger: Ankle Replacements

Since somebody has yet to discover the fabled fountain of youth, we can expect to have to deal with the ordeal of aging. For many of us, it’s the joints that can be the first to go. I’m sure that you are familiar with knee replacement surgery, and I bet you know at least a little something about hip replacement surgery. But what about ankle replacement surgery?

Because the ankle joint is so much more complex than the knee joint or the hip joint, in terms of biomechanics, up to this point, ankle replacement surgery has been more rare. Historically, three times out of four, patients undergo ankle fusions in order to address ankle issues; however, this can cause the other joints in the body to have to take on more stress. Or, another common alternative have been ankle braces, but they still leave something to be desired.

While prosthesis technology for knees and hips has made great advances over the years, developments in ankle prostheses have been slow. It is more common for people to get new knees or hips at a younger age due to the replacements being able to last longer, while ankle replacement parts only lasted 5 – 6 years.

Fortunately and finally, the latest developments on the market can now last 10 – 15 years, opening up the possibility for more people to go through the procedure earlier, when they are more likely to benefit from a new ankle. Recent studies are showing that, with these new replacements, patients are able to restore normal motion and, while they still probably shouldn’t go bungee jumping or run a marathon, they can walk, hike, and jog for short distances.

Nevertheless, the indications for ankle replacements are still more narrow than for knee or hip replacements. Patients with arthritis are excellent candidates, as long as they do not have diabetes or other certain diseases. Still, progress is being made. Technology and medical research continue to catch up and make ankle replacements a reality for more and more people who need them, which is a truly exciting step in the right direction.

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.