Health Beat

When to get help for painful joints

2011-07-06T22:36:00.000-07:00

(ARA) - If your arm goes numb and your speech is slurred, you know you need to seek immediate medical attention. When you nick yourself shaving, you know you can deal with it yourself.

But for the vast number of maladies in between, it can be difficult to know when to go to the doctor and when to deal with it on your own.

One of the most difficult situations in which you need to make the "home care vs. professional care" decision may be when something affects your joints. The joints do some important work for the human body, and figuring out when things will get better on their own and when you may have a more serious problem is not easy.

When to seek help
William Ungureit, clinical director of the physician assistant training program at South University in Tampa, Fla., says there are some important signs that will tell you when to seek professional care.

"If the joint is warm to the touch and swollen, seek immediate help," Ungureit says. "Those are signs of a possible infection, something that won't get better on its own."

Likewise, if you know that the joint pain is the result of an injury such as a fall, put an ice pack on the injury and seek help right away. This type of injury will usually be accompanied by swelling and the inability to bear weight.

Otherwise, painful joints often can be treated at home with over-the-counter pain relievers such as ibuprofen or naproxen sodium. And what about ice and heat?

"Cold therapy (ice) can be used for chronic injuries, such as pain after running," says Ungureit. "Heat therapy is recommended for injuries that have no inflammation or swelling. Heat is ideal for sore, stiff, nagging muscle or joint pain."

If you decide to treat the pain at home, you still need to see your primary care physician if the pain lasts more than two weeks. Your physician may offer prescription pain relievers or other treatment.

Chronic joint pain
Treatment for chronic joint pain may be more involved, Ungureit says. "Non-inflammatory joint pain usually signifies osteoarthritis, which is caused by trauma to the joint or degeneration of the joint tissue in weight-bearing joints." That means the knee, hip and spinal joints.

According to the U.S. Bone and Joint Initiative, a movement sanctioned by the World Health Organization, one in five Americans has some form of arthritis. And contrary to the perception that arthritis is a disease of the elderly, more than half of those with arthritis are under the age of 65.

There is no cure for osteoarthritis, but it can be managed with pain killers, physical therapy, steroid injections such as cortisone, or other injections to help lubricate the joint. As a last resort, surgery to realign or completely replace a joint may be an option. Complete joint replacement is now available for the knee, shoulder, hip and ankle.

Motion is lotion
Although you can't prevent osteoarthritis, you can do things to help lessen its onset and its painful effects. "Losing weight and exercising regularly are great ways to combat osteoarthritis," says Ungureit. "When it comes to joints, we say that 'motion is lotion.' Dropping five or 10 pounds may not seem like much, but five pounds per step adds up fairly quickly on your joints."

What about herbal supplements and other alternative treatments for joint pain? Ungureit says there's nothing wrong with trying them, but make sure you tell your doctor which ones you are thinking about taking, since some supplements can interfere with other medications.

So while you may not need to consult your doctor for every ache, there are some serious signs to look for, and some effective steps that both you and your doctor can take to help relieve those painful joints.

Take care when bringing baby home

2010-03-07T09:59:00.000-08:00

Mommy, daddy and puppy make three ... then along comes baby. Dogs may be affected by the arrival of a new baby, so the American Veterinary Medical Association (AVMA.) offers some valuable advice to new parents. http://www.avma.org/

Before the baby arrives, a dog needs to adjust to not being the baby in the family anymore.
Begin training the dog to observe a schedule -- treats at a certain time of day, walks at a certain time of day.
See how your dog adjusts to children by setting up a meeting with somebody else's children. Keep the dog on a leash. If the dog is scared or aggressive, consult your veterinarian and use great caution.
When the baby comes home, include your pet. Let the dog greet the new mom, who has been missed while she was at the hospital, and then sniff the baby as well.
Keep the dog on a leash or just use a used baby blanket.
Once the baby is home, doggie and junior shouldn't live separate lives. Don't ban the dog from the baby's room, but never leave them together unsupervised.

Safety is on the checklist

2010-03-02T16:12:00.000-08:00

It's safe to say that most passengers feel a tad safer knowing that airline pilots go through a checklist of features before each flight. Heck, Hollywood has made ticking off a checklist an adrenaline-induced thrill ride. "Go, no go for launch."

Well, checklists are making an impact in the operating room as well. It's not foolproof but it is measurable.

MAKING A BETTER MEDICAL SAFETY CHECKLIST

More women dying from pregnancy complications; state holds on to report | California Watch

2010-02-03T10:40:00.000-08:00

More women dying from pregnancy complications; state holds on to report California Watch

This is a very interesting story, which is made even more intriguing because the state is withholding specifics. I tried following through with other data sources I'm familiar with to see how Tulare County fared but none of them publicly track maternal death rates. Pregnancies are always a hot topic here in Tulare County because of our high teen pregnancy rate.

The reports I saw did indicate that infant mortality fluctuated between 4.8-6 percent, not much different than what you would find around the state. At least that's what records from 1996-2006 show. They don't update these things in real time - even in the computer age.

END NOTE: Pre-natal care is an essential component of a healthy mother and baby. The Centers for Disease Control say leading causes of maternal death are: hemorrhage, hypertensive disorder, pulmonary embolism, amniotic fluid, embolism, infection, and pre-existing chronic conditions (such as cardiovascular disease).

The Joint Commission on Accreditation of Healthcare Organizations (it now just goes by Joint Commission, which fails miserably as a name because it really doesn't describe what it does) quoted a CDC physician as saying the trend in maternal deaths is "the tip of the iceberg," of other issues that need addressing. As a result, the Joint Commission has issued some new rules of thumb for medical centers as they treat pregnant women or any woman who could potentially be pregnant.

Striking a balance in health costs

2010-02-02T15:10:00.000-08:00

For those of us on the consumer end of the health care industry, the issue of how medical centers are paid for their services seems a impenetrable morass of red tape. I'm sure the medical centers would say the same.

Take this recent post by Nick Jacobs, a former medical center administrator and blogger, who digs into the issue of the Center for Medicare and Medicaid Services' decision to stop paying for the treatment of preventable medical complications. Translated: that means 'things that happen under a physician's care.'

On one level that makes sense - essentially the government saying "we're not paying for stuff you screw up." However, Jacobs wonders if fear of the non-payment "stick" will have medical centers more focused on preventing errors than in broader issues of health, such as diet, exercise and stress factors. Would the government, or any payer, get more bang for the buck by offering incentives, the "carrot." A balance needs to be struck between the two. It's a bit heavy on the stick side right now.

I'm sure it could be argued both ways. Truly, it should not be an either/or situation. And as always, it will debated for a long time.

END NOTE: How will cost-cutting measures effect our quality of care? Tightening the belt around government bureaucracy is one thing. Further tightening of the belt around the neck of the health care industry is quite another.