Understanding Chronic Pain & Pain Management

Chronic pain is a phrase often heard in medical practices, but what does it actually refer to? Aaron Lloyd, MD, is a pain specialist at Methodist Hospital for Surgery (MHFS) and recently shared some of his expertise and insight on this topic.

According to Dr. Lloyd, the term chronic pain describes a large and varied group of conditions, which makes it impossible to offer a single treatment solution. The underlying causes of pain are also varied, but often include one of the following:

  • Ongoing pain following an injury
  • Pain associated with an ongoing medical disease that has been medically treated but cannot be completely eliminated (e.g. rheumatoid arthritis)
  • Pain associated with a medical disease that causes irreversible injury and painful symptoms (e.g. diabetic neuropathy)

Dr. Lloyd believes the term “chronic pain” has become too commonplace among patients today. While some pain can be attributed to the sources listed above, there are also instances in which the patient simply needs to take greater responsibility for their health, wellness and management of any disease present. Overall, according to Dr. Lloyd, there also needs to be a decreased expectation of quick fixes and pills that claim to solve all pain.

When treating those with chronic pain, Dr. Lloyd finds it helpful to ask his patient to define what outcome(s) they expect in specific, concrete terms. For example, rather than leave it at, “I just want to be pain free” or “I just want to go back to normal,” Dr. Lloyd guides patients toward defining acceptable alternatives in terms of functionality. An example of this would be for a patient to say, “I want to be able to take care of my grandchildren” or “I want to be able to go for a 30-minute walk without sitting down.” These specific goals give Dr. Lloyd and his colleagues a measuring stick to guide their medical care.

While all pain is different, common treatment options for chronic pain include physical therapy, cognitive training, chiropractic care, medication management and surgical referrals. Dr. Lloyd warns against any type of pain treatment that promises a quick fix or any one therapy that claims to be the most successful for treating chronic pain.

In Dr. Lloyd’s opinion, what sets MHFS apart in the area of pain management is that the facility has unprecedented access to colleagues and state-of-the-art equipment, allowing pain management physicians to be an integral part in the MHFS competitive advantage in providing unprecedented patient care. Find out how his team of specialists can assist you by contacting our business office.

dallas mri imaging

What is a Medical Imaging Center?

To aid the diagnosis of various diseases and physical ailments, doctors often rely on diagnostic images of internal systems, organs, muscles and bones. Medical imaging centers, which may be standalone or attached to a facility and provide routine diagnostic and imaging services, help expedite the overall diagnostic process.

But not all imaging centers are created equal. To better understand what sets select imaging centers apart from the rest, Bobby Himel, the Imaging Manager at Methodist Hospital for Surgery (MHFS), shared his expertise and insight.

Interestingly, Mr. Himel began by noting that patients should know about the manufacturer and model of equipment being used at whatever imaging center they’re visiting. It’s just like buying a new car or home appliance—you know that some manufacturers stand above the rest. General Electric is the equipment manufacturer of choice at MHFS, and is one Mr. Himel regards as a top provider.
In addition to manufacturer information, patients should feel free to ask whether equipment is calibrated regularly and if routine preventative maintenance has recently been performed. Patients who make this type of inquiry at MHFS are provided detailed information, including preventative maintenance records and calibration information.

Of course the quality and reputation of imaging center staff tops the list of important factors, because equipment is only as good as those operating it. To that end Mr. Himel explains that all imaging center technologists hold advanced certifications in their respective fields. Similarly, the radiologists who interpret diagnostic tests are board-certified in radiology and can be further certified in select specialties. For example, if a patient at MHFS has an MRI of the knee, the MRI technologist who performs the study will hold an advanced registry in MRI; the radiologist who then interprets the study will be a board-certified orthopedic radiologist. At some facilities, Mr. Himel cautions, you may find an X-ray technologist who performs the MRI and a general radiologist who interprets the test.

Mr. Himel further explains that the MHFS imaging department holds an advanced certification with the American College of Radiology in CT and MRI. The rigorous process for certification ensures the quality of the scans performed at MHFS and ensures safety to the patient, helping the Imaging Center at MHFS stand out from all others.


Understanding Total Knee Replacement

Of all the orthopedic surgeries available to patients, perhaps one of the most common is total knee replacement surgery. While this surgery has historically been reserved for older patients—typically mid-60s and on—newer technology is opening the door for younger patients to reclaim an active lifestyle following a knee replacement.

According to Dr. William Tucker Jr., an orthopedic surgeon at Methodist Hospital for Surgery (MHFS), the most common reason for a patient to undergo total knee replacement is arthritis, although the reason for the arthritis can vary. While arthritis is typically the result of cumulative wear and tear or medical conditions such as rheumatoid arthritis or lupus, some arthritis is brought on by previous sporting injuries.

For Dr. Tucker, the average age of one of his patients undergoing total knee replacement is approximately 63, although this age has decreased over time because the implants within the knee are more durable and the results much more predictable. Previously, patients would be advised to “tough it out” for many years before having their knee replaced. Nowadays, Dr. Tucker says he recommends patients undergo surgery as soon as their symptoms start to interfere with their quality of life or desire to remain active.

Newer techniques, such as minimally-invasive knee replacements, partial knee replacements and implant design have changed the way many orthopedic surgeons look at joint replacement. The newer knee implants are expected to last more than 20 years and give patients a better range of motion, so it’s easier for them to bend their knee, making the prosthesis feel more like a natural knee. This technology helps younger patients decide to go forward with total knee replacement surgery because they can better be assured that their quality of life will improve if they are no longer in constant pain and discomfort.

According to Dr. Tucker, total knee replacement is one of the most successful surgeries in all of orthopedics. Most patients are able to return to virtually all of their normal activities. The primary goal of the surgery is to relieve pain while also improving mobility and range of motion. Following surgery, patients can typically return to walking, playing golf, traveling, gardening and even lower impact sports such as doubles tennis or snow skiing, if they are comfortable doing so.

For Dr. Tucker, who is been in practice for 19 years, MHFS is set apart from other hospitals because it offers patients a facility which specializes in the care of surgical patients with a streamlined model that decreases wait times, minimizes the amount of time patients need to spend in the hospital after surgery, lowers the risk of infection and other complications, all while providing an unsurpassed patient experience.


Methodist Hospital for Surgery named in top 10

Methodist Hospital for Surgery was recently named one of the top 10 cleanest hospitals in Dallas by Becker’s Hospital Review.  Patient care, quality and satisfaction are of the utmost importance and Methodist Hospital for Surgery is honored to be recognized.

Read the original article here.


Understanding Carpal Tunnel Syndrome

What exactly is carpal tunnel syndrome (CTS)? The carpal tunnel is a narrow passageway of ligament and bone at the base of the hand and it houses the median nerve, which runs through the forearm into the palm. CTS occurs when the median nerve becomes compressed or squeezed at the carpal tunnel site.

As for the “why,” call it a common condition of living. We use our hands every day; eventually, wear and tear sets in, which is one reason CTS is generally associated with older adults. Pregnancy is actually another common cause. During pregnancy, excessive fluid can cause tissue swelling and pressure on the nerve.

So everyday use of the hands is the most common culprit for CTS, but certain medical conditions can also leave patients predisposed to the disorder. In addition to pregnancy, these include diabetes, some auto-immune arthritic conditions and untreated thyroid disease. Some experts believe that occupations involving heavy vibration to the hand, such as use of a jack hammer or consistent and repetitive forceful gripping, may also lead to CTS.

If you suspect you have CTS, look for the most common symptom:

numbness or tingling in the fingers

You may notice it throughout the day, while sleeping or when you first wake up. If untreated the numbness can eventually become permanent and lead to motor loss or weakness.

The first level of treatment for CTS is almost always a wrist brace, which keeps the wrist still and gives the affected tendons opportunity to heal, and may be used in conjunction with non-steroidal anti-inflammatory medications. If symptoms persist or become moderate to severe, patients can either receive a cortisone shot into the carpal tunnel or be recommended for surgery.

Corrective surgery for CTS is almost always effective, provided the diagnosis is correct and the patient did not wait too long to receive treatment. Carpal tunnel surgery is an outpatient procedure that uses local anesthesia and takes only five or so minutes to complete. Patients receive a couple of stitches and a small dressing on the hand and are instructed to not use their hand for two weeks while the wound heals.

Want to discuss possible carpal tunnel issues with an orthopedic specialist at Methodist Hospital for Surgery? Call us today at 469-248-3900.


How to Choose Between a Podiatric Versus Orthopedic Surgeon

Navigating America’s healthcare system can be a daunting task, especially when patients are faced with choosing a specialist to address their specific need. Further complicating the matter is having to choose between two specialists that seem similar, like a podiatric versus orthopedic surgeon. What is the difference? And how is a patient to know which is the better choice for their specific condition?

According to Kevin Myer, a doctor of podiatric medicine at Methodist Hospital for Surgery (MHFS), there are probably more similarities than differences between these two specialties. In terms of practicality, a general orthopedic surgeon is capable of treating all bones, joints and soft tissues of the body, while a podiatrist is focused on the foot and ankle specifically. Additionally, a foot and ankle orthopedist is going to manage aspects of the foot and ankle that pertain to the bones, soft tissues and joints of the foot and ankle, while a podiatric doctor actually manages all these same aspects, as well as the dermatology and biomechanics of the foot and ankle.

Dr. Myer also points out that, from an educational background, the core difference between the two specialties is that orthopedic doctors specialize in medical and surgical management of all the bones and joints of the entire body, while podiatric doctors focus on the foot and ankle from day one of podiatric medical school and thereafter in residency. Although podiatric and orthopedic training is very similar in terms of core sciences and exposure to various medical specialties in residency training, the podiatrist approaches each phase of his medical school and residency training with an emphasis on the foot and ankle.

So which choice should a patient make between an orthopedic versus a podiatric surgeon?

Whether the patient is having a bunion fixed or an ankle fracture repaired, if they are working with a well-trained podiatric or orthopedic surgeon, Dr. Myer believes the outcome will be similar between the two specialists because they were trained with similar principles and utilize the same equipment to accomplish the repair.

A patient should always choose a specialist in whom they are completely confident, but Dr. Myer recommends that, when it comes to specific treatments of the foot and ankle, a patient should probably not opt for treatment from a general orthopedist. A podiatric or orthopedic foot and ankle surgeon is highly specialized in treating specific areas, whereas the general orthopedist is likely more adept at managing hips, knees and shoulders, as opposed to the foot and ankle.

If you are in need of a podiatric or orthopedic specialist, Dr. Myer praises the expertise represented at MHFS in his fellow colleagues, as well as their genuine care and concern in addressing the medical problem at hand and not just performing another surgery. If you would like to schedule an appointment to speak to a podiatric or orthopedic specialist, please call 469-248-3900.


Treat Your Feet Right

April is National Foot Health Awareness Month, which means now is a good time to take a closer look at your own feet and ask whether your shoe choice is helping or hurting them. According to Dr. Rick Miller, a podiatrist at Methodist Hospital for Surgery (MHFS) who’s been in practice for more than 35 years, shoe choice can play a major role in the overall health of feet.

Among the more common foot problems he treats, including bunions and hammer toes, most are found in women who wear high-heeled shoes (higher than an inch and a half) with an enclosed, pointy toe. This pushes toes upward and causes them to cramp, and also causes corns when toes rub against the inside of the shoe.

While Dr. Miller isn’t suggesting a woman should never pull out some killer heels for a special evening out, he does encourage sensibility in daily shoe choice. For instance, if a woman knows that in the course of the day she’ll be doing a lot of standing or walking, wearing high heels is not a good choice. However, if she’s going out to dinner and doing more sitting, then making a great entrance in high heels would be more appropriate.

But it’s not just women who need to match their shoe choice to their activities. For example, Dr. Miller often sees people at amusement parks walking around in flip-flops that offer no arch support and no protection for the toes. This shoe choice will fatigue the person wearing them more quickly than if they were wearing shoes with proper support. In a casual situation that requires lots of walking, Dr. Miller recommends a walking or running shoe that offers good support, lots of cushion and plenty of room for toes.

So what is the long-term outlook for those patients Dr. Miller sees who continue to make the wrong shoe choice? He said those patients could probably expect pain in the lower back, knees and arches, as well as deformities of the toes and ingrown toenails. To properly treat the effects of poor shoe choice, such as bunions, calluses and corns, patients should seek a medical professional to have them properly removed or trimmed, and then wear padding to keep them comfortable. If patients continue making poor shoe choices, then surgical procedures to correct deformities or even nerve damage may become necessary.

To learn more about what the podiatrists at MHFS can do to keep your feet healthy, please call 469-248-3900.


Launch of New Spine Surgery Program

We just experienced an exciting moment in the life of our hospital!  Our new Spine Surgery Program kicked off on Tuesday, May 6, with our first Spine Wellness Class.  The turnout was wonderful to see, and we were thrilled to hear several patients comment that their concerns were alleviated.

The Spine Wellness Class is led by Candace Callegan, Nurse Navigator.  Candace has more than 27 years of experience in nursing.  Her positive, practical, and humorous presentation helps patients to understand the recovery process and gives them the confidence to quickly return to an active lifestyle.

The Spine Surgery Program offers a broad spectrum of surgical and interventional treatments making the program appropriate for chronic pain patients and surgical candidates alike.  Patients of the program will have the ongoing support of Candace who will guide them through the entirety of their treatment.


Ready, Set, Go: Sports Season & Adolescent Injury

The warming days of spring are right around the corner, which means parents and kids are gearing up for sports season. Whether it’s organized school or community sports or just playtime in the front yard with friends, kids are exceedingly active—and far more prone to injury—when weather gives them the freedom to be outdoors.

That means parents need to be ready for the risks of sports and outdoors activities.

This month, Dr. John McGarry, an orthopedic surgeon at Methodist Hospital for Surgery (MHfS), sheds some light on the precautions that could help prevent unnecessary injuries. In Dr. McGarry’s experience, the three most common sports injuries in children and adolescents are strains and sprains; overuse injuries such as stress fractures, apophysitis (inflammation of the bone) and periostitis (inflammation of soft tissue); and contusions.

Sprains and contusions are the most difficult kind of injury to avoid because they usually occur during play as a result of falls, collisions or missteps. On the other hand, overuse injuries can be readily avoided by gradually increasing intensity during practice or training, until the participant has re-attained the desired level of fitness; moving too fast from winter stillness to high-speed summer activity is what quickly leads to overuse injuries. Similarly, strains can be avoided by properly warming up with stretches and slow, simple exercises before high-intensity activity begins.

But injury can still be unavoidable. If your child sustains an overuse injury, Dr. McGarry recommends the following as treatment:
• Ice
• A non-steroidal anti-inflammatory drug (NSAID, such as ibuprofen)
• Rest
• Stretching
• Slow return to sports

Treating strains, sprains and contusions depends on the severity of the injury, though initial treatment will mirror the above (ice, NSAID, rest, stretching). In worst case scenarios, fractures or muscle tears may require orthopedic surgery, in which case the concerns include risks of surgery, healing time and how quickly a child can return to normal activity or sports involvement.

While every parent hopes to survive the sports season with their kids injury-free, medical intervention is almost always necessary for someone. In Dr. McGarry’s opinion, MHfS is exemplary in the field of child and adolescent orthopedic surgery thanks to fellowship-trained sports medicine surgeons who routinely care for adolescent athletes. For specific questions about adolescent orthopedic surgery, call Methodist Hospital for Surgery at 469-248-3900.