Monday, December 23, 2013

from the Doctor's Desk: ACL Tear

What is an ACL (Anterior Cruciate Ligament) Tear and How is it Treated?

The ACL is one of the four primary ligaments that connects the femur bone and the tibia bone (see Fig 1).  Many patients have heard of this ligament injury in relation to professional athletes injuring their knee and missing much or all of their season.  The ACL helps stabilize the knee both in a front-to-back direction and also rotationally.  Without an ACL many patients report that their knee “gives way” or feels unstable when they turn or pivot. 
Fig 1 - courtesy AAOS

Usually an ACL injury is traumatic.  Many patients describe a specific event where their knee is either hit or turns quickly and they feel a “pop” and immediate pain. Usually swelling and stiffness develops very soon after the injury.  This typically decreases over a week or so from the injury.   Often, when an ACL is torn there are other injuries to the knee.  One of the most common associated injuries is the meniscus, the cartilage padding or cushion between the bones.  A meniscus injury causes pain along the side of the knee and a sharper, catching pain at times.

An ACL tear is typically identified through a physical exam and an MRI.  The physical exam often shows that the tibia will slide forward relative to the femur.  An MRI will show that the ligament is torn (see Fig 2).
Fig 2 - courtesy AAOS

Treatment options fall into two primary categories, surgery or more conservative treatment.  A choice to consider surgery depends on multiple variables including:  current symptoms (does the knee feel unstable?), expected activity levels (does the patient expect to return to an active lifestyle that requires pivoting on the leg?), and the patient’s age and medical status.

For example, an older patient that doesn’t complain of the knee instability, has medical problems, and walks on flat surfaces for exercise, may do well with conservative treatment.  In this case, we start with physical therapy to regain motion and strengthen the surrounding structures of the knee.  Some patients also benefit from a knee brace to further stabilize the knee.  

In comparison, a younger and more active patient that has ongoing instability of the knee and expects to return to sporting activities, would likely benefit from surgery.  We’ll talk more about the surgery and the recover process in the next article.  

Click Here is a little information and Video from our Website.

DaneGlueck, MD – December, 2013

There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C.

Wednesday, October 16, 2013

Wellness Wednesday / "Delia's Dose"

Do you have any of these symptoms?

*decreased vision or other eye problems
*decreased night vision
*pain in one or both eyes
*trouble with contact lenses
*bulging eyes
*ringing or buzzing in your ears
*intolerance of noise
*epileptic seizures
*headaches, migraines-can be severe
*dizziness, unsteadiness
*confusion, memory loss
*severe drowsiness and sleepiness
*numbness of the limbs
*hyperactivity and restless legs
* facial pain
*severe depression and or irritability
*personality changes
*palpitations, shortness of breath
*nausea, diarrhea
*abdominal pain
*pain when swallowing
*itching without a rash
*aggravated allergies
*thinning or loss of hair
*severe PMS
*excessive thirst, fluid retention

Last week’s blog was about regular soda. Which, if you read, you know I don’t really approve of….but this week I want to start talking about DIET SODA…more so…a major ingredient in diet soda. This is a MAJOR DELIA’S DOSE…so grab a cup of coffee and dig in… because there is an ingredient in diet soda and many many other things that GREATLY upsets me!  

Anyone that really knows me knows that I absolutely am against any food or beverage that contains ASPARTAME. When I see my family, friends and coworkers drinking this stuff…I just want to grab it out of their hands and say…”That’s Poisonous!! Stop!”   There are a TON of studies and scientists out there saying that aspartame is safe….well, this is MY blog so I can write about what I want…and I feel deep down in my soul that this stuff is NOT safe!!

Diet Soda is made with ASPARTAME (AKA NutraSweet, Equal, Spoonful)
What is Aspartame? It is a sugar substitute. It does not occur naturally, it is a manufactured substance, and is about 200 times sweeter than regular sugar. A guy named James Schlatter was a chemist for G.D Searle & Co, he was working on an anti ulcer drug and only discovered how sweet this stuff was when he got some on his finger and licked it!  Aspartame was introduced into our food supply in the early 1980’s. Since its approval by the FDA it has been a very controversial topic.  It is made up of 3 different chemicals. Now, all 3 of these chemicals are found naturally in nature, 2 of them are essential to our body. When they are separated in a lab from their NATURAL state….that is when they can cause problems for us.

Aspartic Acid is an amino acid. Amino acids are the building blocks of protein and make up 75% of our body! They are essential to almost every bodily function that we have. This particular amino acid is considered a “non-essential” one because our bodies produce it on its own…some we cannot produce and have to get through our diet, those are called “essential”…but when this aspartic acid is digested in its “free form,” meaning, when it’s not attached to a big chain of other amino acids or chains of protein, it can be dangerous for us. Our body knows how to break it down when it’s in its natural state…but otherwise our body cannot digest it and it quickly enters the brain and our nervous system. This triggers a lot of free radicals. Those crazy things are actually damaged cells (caused from bad eating habits, or external environmental toxins, smoking, excessive alcohol use. If you take care of yourself, you probably have enough antioxidants and a good immune system to keep these free crazy radicals at bay) that go on a rampage in your body and attack other cells to get whatever critical thing they are missing! So these free radicals basically kill cells because they literally stimulate or “excite” the cells to death! They over stimulate the brain cells. They are called Excitotoxins (I love that word..I think I’ll be one of those for Halloween!)  Anyway…this Aspartic Acid makes up 40% of Aspartame.

This particular amino acid  is a neurotransmitter that helps send information from neuron to neuron. Let’s go back to basic chemistry class(which I think I slept through in high school). Neurons are cells that make up our nervous system. They are responsible for sending information throughout our entire body. There are different kinds of neurons, like sensory and motor, and they send info to our brain and muscles. The difference between neurons and other cells in the body is that once they die they are not replaced. We stop reproducing them shortly after we are born. Apparently though, new connections between neurons do form throughout life, but again, once they are gone, they are gone!
Sooo, why is this so important to understand? Because too much ASPARTATE in the brain kills certain neurons. Remember, once they are dead, they are gone forever. No more neurons for you! Hmmm, no wonder many people who drink or eat excessive amounts of aspartame complain of memory loss, migraines, fatigue, anxiety attacks, sleep problems, depression, and vision problems.

 This stuff makes up 50% of Aspartame. It is also an essential amino acid. Some people have a genetic disorder called PKU, they lack a certain enzyme that breaks down phenylalanine the right way so the body can use it properly. In fact new born babies in the USA have a PKU test before leaving the hospital. If you have the disorder and your levels of this stuff are too high, it can cause major developmental delays. If you have PKU you have be very watchful for products that contain phenylalnine, otherwise you are at risk for seizures, concentration problems, mental confusion and impaired memory. Phenylalanine is found naturally in eggs, meat, milk and bananas. When it’s not combined with other amino acids it can cause problems for a lot of people. Even if you don’t have the genetic disorder, high levels of isolated phenylalanine can cause itching, swelling, tingling in the mouth, heartburn, nausea, constipation, dizziness, headaches, anxiety, and trouble sleeping.  This is also considered to be in the category of “excitotoxins” and again, when it is in its UNNATURAL, “free form” state, it is  unhealthy for us!!
There is something called the blood-brain barrier..think of it like a big web (it’s made up of “specialized capillary structures”) that help to prevent toxic substances from entering the brain. In the womb, the blood brain barrier is still developing and if the mother is ingesting a lot of aspartame, these free form excitotoxins can cross over the blood brain barrier, just as alcohol can, during pregnancy, and effect your unborn child. Cerebral dysfunction, irreversible brain damage, developmental delays, even some studies are saying that the rates of Autism in this country have risen greatly because of the use of aspartame since the 1980’s in our country.

METHANOL: You may have heard of this…it’s actually wood alcohol. Yes, you can go buy this at your local hardware store. Would you open up the container and drink it!?!? Now, Methanol is found in fruits and vegetables, but it always is found along with ethanol and pectin which are kind of like antidotes. Basically ethanol and pectin stop methanol from being turned into formaldehyde in your body..yeah, that’s the stuff they use for embalming fluid! Well, aspartame is made up of 11% methanol. It does not have ethanol or pectin along with it, so when we consume low doses of this stuff it actually can convert to FORMALDEHYDE in our bodies!  If you look up methanol…most descriptions of it saying something like, “it should never be ingested, inhaled or come into contact with your skin….highly poisonous.” Hmmmm. When methanol is all by itself, not attached to ethanol, it breaks down into formaldehyde and is slowly excreted into our body. This is especially the case when it is heated to above 86 Fahrenheit
(my normal body temp is 98.6, what’s yours?!)….like when you make sugar free jello…or like when our troops in Desert Storm were given aspartame laden beverages which had been stored in the hot desert! Many of them came home with symptoms of formaldehyde poisoning…headaches, ear buzzing, dizziness, nausea, vertigo, numbness, blurred vision.

So, those are the 3 ingredients that make up ASPARTAME. Sounds delicious doesn’t it!!?? POISON I say.

You ask…”Delia, why would the FDA approve this stuff if it isn’t safe!?” Well…without getting into the politics of it all…let’s just say that the FDA actually denied approving aspartame for years until… Donald Rumsfeld was the CEO of G.D. Searle Laboratories…soon after he became a part of President Reagan’s transition team, he appointed the new FDA commissioner.  This guy was the first commissioner in 16 years to  overrule the scientific review panel and approve aspartame! The FDA actually urged Congress to prosecute G.D. Searle for supplying false data about their findings on aspartame and for “concealing facts”. Well, the 2 lawyers that had been assigned to the case, by our government, decided not to prosecute and then joined G.D. Searle law firm! Hmmm, wonder what their signing bonuses were? Obviously money was and probably still is involved with the fact that aspartame is in our food supply.

And get this… In 1992, the US Air Force warned all pilots not to use aspartame. In the flight safety journal is says, “some people have suffered aspartame related disorders with doses as small as that carried in a single stick of chewing gum. This could mean a pilot who drinks diet sodas is more susceptible to flicker vertigo, or flicker-induced epileptic activity. It also means that all pilots are potential victims of sudden memory loss, dizziness during instrument flight and gradual loss of vision."  WHAT?!?! Why isn’t this a law that ALL pilots flying planes not use aspartame?? Think about that, if the FAA had a public warning about this…then the FDA would have to explain to us why they don’t have any public warning about this stuff and why it’s still on the market! This could be a whole other blog..believe me!

I could go on and on about cases where people have unexplained health problems!  I truly believe that aspartame consumed on a regular basis over many years can have side effects. They can be gradual or immediate. Illnesses like Chronic Fatigue Syndrome, Lyme Disease, Grave’s Disease, Hypothyroidism, Fibromyalgia, and Attention Deficit Disorder can all be triggered or caused by aspartame!!   

Ok, I think I am done. I could go on and on. What it boils down to, is that this is an UNNATURAL thing. Our poor bodies don’t really know what to do with it! Please start to read labels…be aware of allllll the things that have this “Sweet Poison” in it.  Think about gum…almost EVERY gum at the store has aspartame in it….I found a brand that doesn’t, thank goodness…cause I did not want to give up gum, in fact I am going to chew a nice piece of my aspartame free gum right now to celebrate that I am done with this blog! WHEW!!

Have a Healthy Week!

Wednesday, October 9, 2013

Wellness Wednesday / "Delia's Dose"

This week’s blog is inspired by a discussion I recently had with my daughter….”Mommy, why can’t I have soda?”  My answer: “Because it has absolutely NO NUTRIONAL VALUE!”   Her response: “Mommy, what does absolutely mean?”


Let’s talk about the ingredients in soda:

High-fructose corn syrup—no nutrition what so ever! It is a very common sweetener found in a TON of our foods today. Funny how since this has been added to our foods, the levels of obesity and diabetes in our country continues to rise.

Caffeine—a diuretic and stimulate that can be addictive.

Phosphoric Acid—a chemical that adds a sour or tangy flavor, it breaks down starch to sugar!

“Natural flavors”—there is usually nothing natural about the things they add, they are manufactured and are just adding flavor like citrus or cola, just more sugar.

Caramel color—get this….the Center for Science in Public Interest actually filed a petition with the FDA to ban this stuff from soda! This is made by reacting sugars with ammonia and sulfites under high pressure and temperatures. This chemical reaction creates 2 and 4 –methylimidazole, which studies show, causes lung, liver, and thyroid cancer!!!

Carbonated water—plain water infused with carbon dioxide—this creates those bubbles that a lot of folks I’ve talked to say is one of the things they love about soda.

REGULAR soda is just drinking pure sugar. 12 ounces of that very famous soda that is in a red can with the white letters has 39 grams of sugar and 140 calories. 140 calories from sugar! “But Delia, I only have one soda a day, for my treat!” I’d say that’s fine…if you worked out 3-5 times a week and ate a healthy diet..but if you don’t….and you are wondering why you just can’t seem to lose weight…well, if you take that 140 calories a day x 365 days=51, 100 calories a year…there are 3, 500 calories in 1 pound….so that’s an additional 14.6 pounds a year that you’ve added to yourself!

Plus...I don’t have to tell you that sugar is not good for your teeth. I also am pretty sure you know that a lot of excess sugar in your diet greatly increases your risk for diabetes. When the body processes that sugar, your pancreas has to do its job and release insulin to help your body use the sugar as energy….but when you eat and drink too much sugar…your pancreas gets worn out!!

Since I need an ENTIRE blog to discuss what I feel is the most EVIL liquid on the planet….DIET SODA…I am saving that for next today I want to leave you with a delicious smoothie recipe I have discovered! Much better than that soda!!
Continuing on with my pumpkin theme from last week…

Blueberry Pumpkin Pie Protein Shake
1 cup unsweetened almond milk(I’ve used coconut milk and regular milk too)
½ cup pureed pumpkin(right out of the can)
½ cup frozen blueberries(I’ve used mixed berries)
1 tbsp cashew butter(or almond butter or all natural peanut butter)
2 tbsp protein powder
¼ tsp cinnamon
¼ tsp nutmeg
a dash or two of ground cloves

Add all ingredients to a blender or food processor
Blend until completely combined
Top with a little more cinnamon if you want

Have a Healthy Week!

There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C