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Apr 21 2010
Preventing Baseball Injuries Q&A - DSH

Category DMC Physician Spotlight

0

doctor photo
Dr. Henry Goitz, M.D.
Sports Medicine/Orthopaedic Surgery
DMC Surgery Hospital (DSH)

www.dmcsurgeryhospital.org

In preparation for the start of baseball/softball season, we wanted to give out some information to players of all ages on how to help prevent sports-related injuries. So we had asked one of our top sports medicine orthopaedic specialists, Dr. Henry Goitz from DMC Surgery Hospital, to answer a few questions about how to both identify and help avoid these types of injuries during the season. 

Question #1: What are the most common injuries associated with 'throwing' athletes?

Dr. Goitz: Injuries to the shoulder and elbow are by far the most common in throwing athletes. Most of these problems start as overuse injuries, particularly in our youth; but, continued play through pain is a perfect formula for further injury, some of which may actually require surgery. More serious events could involve injury to the growth plate in the skeletally immature adolescent both in the shoulder and elbow; such disturbances could also lead to surgery and/or growth disturbance or deformity.

One of the most compromising events that is on the rise in younger and younger throwers and is of true concern to those of us who manage and treat sports injury is damage to the medial collateral ligament of the elbow, an event that may require reconstructive elbow surgery known as the 'Tommy John'.

Question #2: How often do these injuries occur?

Dr. Goitz: The increasing numbers of injury to our throwing athletes is staggering, considered by some to be of epidemic proportions. The reason is multifactorial. Yet, throwing too much is primarily to blame. Playing year round on multiple teams with multiple back to back games does not allow the arm sufficient time to adapt appropriately to increasing stresses--the result, tissue breakdown, pain, and inablility to play.

Question #3: How can one avoid common injuries?

Dr. Goitz: Muscle stretching and strenghtening, together with proper pre-season conditioning that is sport specific is the best way to reduce the incidence of injury. It's important to work the rotator cuff and forearm musculature, together with a conditioning of the muscle to reduce fatigability.

Question #4: What are some suggested surgical and non-surgical approaches for those who suffer from shoulder related injuries?

Dr. Goitz: Shoulder 'bursitis' and strain of the rotator cuff musculature is best treated by conservative measures that involve stretching and strenghtening of the musculature while reducing inflammation of the painful bursa. Failure to manage this pain could result in arthroscopic debridement (removal) of the painful bursa. Sometimes the bicep tendon anchor that is found deep in the shoulder socket requires arthroscopic reattachment after being torn from its anatomic site of origin.

Question #5: What is the role of physical therapy in recovery?

Dr. Goitz: Physical therapy's role is 'huge'!! Without good physical therapy, more surgery could be required. Good therapy can keep a ballplayer out of the operating room. More important, good pre-season therapeutic conditioning can keep our ball players from getting injured in the first place!!

FOR ALL OUR BASEBALL AND SOFTBALL READERS, HAVE A GOOD SEASON AND LOTS OF INJURY-FREE FUN!!

To make an appointment with Dr. Goitz, please call (586) 558-2860. 



If interested in more information on preventing throwing injuries, come see Dr. Henry Goitz in person next Wednesday, April 28 from 6:30-8pm over at 
DMC Surgery Hospital for a DMC People's Medical College seminar on "Play Ball! Preventing Injuries in Throwing Athletes". The event will feature a live "Ask The Doctor" Q & A with Dr. Goitz and exercise demostrations from therapists and trainers from our DMC Rehabilitation Institute of Michigan (RIM) and is ideal for recreational athletes of all ages, parents, and coaches.

To register for this seminar, please register online here at
www.dmc.org/peoplesmedicalcollege or call 1-888-DMC-2500.




A board-certified orthopaedic surgeon, Dr. Henry Goitz specializes in ligament, cartilage and tendon injuries of the knee, shoulder, elbow and ankle, with surgical expertise in sports medicine arthroscopy.

An honors graduate of Cornell University, N.Y., Dr. Goitz received his M.D. from Rutgers Medical School (UMDNJ), New Jersey. He completed his Orthopaedic Surgery Residency at the University of Virginia, and Sports Medicine Fellowships at University of Virginia and the American Sports Medicine Institute (Birmingham, AL).

He served as Associate Professor and Chief, Sports Medicine, at the Medical University of Ohio. He has been a consultant for Detroit athletes from the professional (Lions, Tigers, Red Wings) to the recreational sports enthusiast, as well as Team Physician for the US Paralympic Team. His cutting edge research has won lecture invitations both nationally and internationally, and syndicated newspaper, radio and television outlets have sought his sports injury-related advice. He is Managing Sports Editor of E-medicine.

 

 

 

 

 



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Mar 30 2010
Breakthrough Stroke Prevention at the DMC (part 3) - DRH

Category DMC Physician Spotlight

1


Dr. Seemant Chaturvedi, M.D.
Director, DMC Comprehensive Stroke Center
DMC Detroit Receiving Hospital (DRH)
www.drhuhc.org

(part 3 of a 3-part series)

In the last two weeks, Dr. Chaturvedi has described the significant advantages of the stroke treatment program at Detroit Receiving Hospital, the advanced skills of the neurology team and their ability to help under very difficult circumstances. He spoke of the program’s dedicated focus and the availability of a neurocritical intensive care unit—a special advantage for stroke patients. This week, Dr. Chaturvedi identifies next steps when you suspect stroke symptoms in a loved one.


"Quick Response Enables Stroke Patients to Recover with Full Capabilities"

As we reported in the previous two weeks’ columns, there are state-of-the-art, highly advanced treatments at Detroit Receiving Hospital that prevent a stroke from causing the damage associated with lengthy rehabilitation. But for the treatments to be most effective, the patient must arrive at the emergency room as quickly as possible after the onset of symptoms. Advanced drugs like tPA must be administered within three hours after the onset of symptoms. Advanced technologies, like the Merci Clot Retriever and the Penumbra are effective if the patient arrives within eight hours of symptom onset. All of these require the skills of interventional neurologists to be successful. The only such specialists in the state and the region are at Detroit Receiving Hospital.

Once you are convinced your loved one is having a stroke, call an ambulance—do not try to drive the patient yourself. Advanced life support ambulances can start an IV that will help prepare the patient for the angiogram, the procedure or drug treatment necessary once he or she reaches the emergency room.

When symptoms of stroke appear, many well educated and intelligent people will go into denial. Some patients with a severe headache, if it’s near bedtime, will "sleep on it," hoping it will go away. During the day, they often wait for the pain to go away on its own. The best option is to have it medically checked to rule out a stroke, because if it is a stroke, every minute counts.

Familiarize yourself with the symptoms: 

  • Sudden severe headache with no known cause
  • Sudden numbness or weakness of the face, arm or leg, especially on only one side of the body
  • Sudden confusion or trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking
  • Sudden dizziness, loss of balance or lack of coordination

If you’re in doubt, the DMC offers a 24/7 nurse answering service, at 1-888-DMC-2500. While this phone call will not replace a physician examination, it will help you assess the patient’s condition for next steps.  

For more information or to consult with a Detroit Receiving neurologist, call (313) 745-1540. 

For more information on stroke prevention and general health information, please visit our DMC Health Library page at http://www.dmc.org/healthlibrary.

 

 


 

Dr. Seemant Chaturvedi is Professor of Neurology at Wayne State University School of Medicine and Director of the Wayne State/Detroit Medical Center Comprehensive Stroke Program. He received his undergraduate degree from Princeton University, completed medical school at the University of Connecticut, a neurology residency at the University of Massachusetts Medical Center, and a stroke fellowship at the University of Western Ontario.

Dr. Chaturvedi has co-edited the books Transient Ischemic Attacks in 2004 and Carotid Artery Stenosis: Current and Emerging Treatments in 2005. He was chairman of the American Academy of Neurology carotid endarterectomy guidelines committee, with the guidelines published in 2005. He is currently on the steering committee of several stroke prevention studies. His research interests include carotid revascularization, intracranial atherosclerosis, and stroke in young adults.

 



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Mar 24 2010
Breakthrough Stroke Prevention at the DMC (part 2) - DRH

Category DMC Physician Spotlight

0


Dr. Seemant Chaturvedi, M.D.
Director, DMC Comprehensive Stroke Center
DMC Detroit Receiving Hospital (DRH)
www.drhuhc.org

(part 2 of a 3-part series)

Last week Dr. Chaturvedi spoke of the Merci Clot Retriever, the amazing technology and the only specialists in the state who can perform the procedure that stops a stroke cold and prevents the disabling deficits normally associated with a stroke.  This week, he’ll describe the program and why it is able to deliver this level of care.

"Skilled Specialists for Stroke Patients"

 

The stroke program at DMC Detroit Receiving is the only one in the state and the region with interventional neurologists. These are specialists who are fellowship trained in stroke medicine, and who have the skill to thread a tiny catheter, equipped with a safety umbrella, through the delicate, intricate pathways of the brain to immediately stop a stroke and prevent the disabling side effects normally associated with it.

Two of these interventional neurologists, Dr. Andrew Xavier and Dr. Sandra Narayanan, have given people back the best years of their retirement with the use of tPA, the Merci Clot Retriever, and yet another technology, the Penumbra, which attaches to a clot and removes it as the catheter is retrieved. These expert skills are in high demand in the emergency room at Detroit Receiving, which sees more than 101,000 patients a year.

Detroit Receiving also has four stroke dedicated, fellowship trained neurologists on staff just for the stroke program. Our program also offers two neurocritical care specialists who staff a highly specialized intensive care unit just for stroke patients. This dedicated ICU is only found at advanced specialty care hospitals, and Detroit Receiving is the only hospital in the region to have one.

Dr. William Coplin, the head of the neurology service at Detroit Receiving, has recruited this team to provide state-of-the-art care for stroke.

Detroit Receiving neurologists also provide telemedicine guidance for emergency physicians at sister DMC hospitals Sinai-Grace and Huron Valley-Sinai Hospital, enabling them to stabilize the patient before sending them via ambulance for treatment.

Two advanced neurosurgeons who are part of the team, Dr. Murali Guthikonda and Dr. Mark Hornyak, step in when there is an aneurysm, or hemorrhaging in the brain. Patients suffering from this are the most at risk, and they particularly benefit from being seen in a dedicated neurological intensive care unit. 20% of brain hemorrhages are due to brain aneurysms, and sometimes there is a coiling of the aneurysm that requires even greater skill to treat.  The outcomes at Detroit Receiving show that having highly skilled specialists on staff 24/7 make a difference for our patients.

with slightly longer delays.

Next week: The importance of acting quickly when stroke symptoms are present.

 

For more information or to consult with a Detroit Receiving neurologist, call (313) 745-1540. 

For more information on stroke prevention and general health information, please visit our DMC Health Library page at http://www.dmc.org/healthlibrary.

 

 


 

Dr. Seemant Chaturvedi is Professor of Neurology at Wayne State University School of Medicine and Director of the Wayne State/Detroit Medical Center Comprehensive Stroke Program. He received his undergraduate degree from Princeton University, completed medical school at the University of Connecticut, a neurology residency at the University of Massachusetts Medical Center, and a stroke fellowship at the University of Western Ontario.

Dr. Chaturvedi has co-edited the books Transient Ischemic Attacks in 2004 and Carotid Artery Stenosis: Current and Emerging Treatments in 2005. He was chairman of the American Academy of Neurology carotid endarterectomy guidelines committee, with the guidelines published in 2005. He is currently on the steering committee of several stroke prevention studies. His research interests include carotid revascularization, intracranial atherosclerosis, and stroke in young adults.

 

 

 



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Mar 17 2010
Breakthrough Stroke Prevention at the DMC (part 1) - DRH

Category DMC Physician Spotlight

0


Dr. Seemant Chaturvedi, M.D.
Director, DMC Comprehensive Stroke Center
DMC Detroit Receiving Hospital (DRH)
www.drhuhc.org

(part 1 of a 3-part series)

"Stroke patients resume normal life when treated by breakthrough technologies"

The stroke program at DMC Detroit Receiving Hospital offers a depth of expertise and experience that provides significantly better options for stroke patients.

Many Americans fear stroke more than death, according to a study published in 2007, because of the after effects—the disabling features that often require months or more of rehabilitation.  But for those of us living within driving distance of Detroit Receiving Hospital, a stroke need not be a life-altering event, although still a serious one.

A drug that has commonly helped physicians stop a heart attack in its tracks was found to have the same effect on a stroke.  The drug, tPA, needs to be administered to the patient within three hours of the onset of symptoms.  When this occurs, the patient re-enters his or her life in the same condition it was before the stroke—without deficits from the stroke itself.  This near-miraculous treatment has already helped hundreds of patients at Detroit Receiving.

However, some stroke patients are in denial when the symptoms begin.  Sometimes, the family member becomes aware of it some while after the stroke has begun.  In this case, not knowing how long the stroke has been underway, physicians in the emergency room must rely on other factors. 

Also, not every patient can take tPA.  If a family member is there to answer questions about the patient’s health history to establish eligibility for tPA, that is of course the best option.  But if the family member is not sure how long the symptoms have been going on, Detroit Receiving’s certified stroke specialists can still help—by using an innovative new technology.

This technology is a very tiny catheter with a tinier umbrella  that the interventional neurologist threads through the brain’s pathways to the clot, removes it, the umbrella trapping any loose pieces that could move on and launch another brain attack.  This catheter, called the Merci Clot Retriever, is only available at Detroit Receiving Hospital because this is the only hospital in the state with interventional neurologists who can perform the procedure.  Like tPA, the results are nearly miraculous in the difference it makes for the patient.  The patient re-enters his or her life without deficits, without the need for months of rehabilitation care, because the Merci Clot Retriever has stopped the stroke and the damage that disables the brain.  The window of opportunity for the Merci Clot Retriever is eight hours from the onset of symptoms, although our specialists have occasionally had the same results with slightly longer delays.

Next week: How the specialists of the state’s first certified stroke program provide state-of-the-art care for all stroke patients.

 

For more information or to consult with a Detroit Receiving neurologist, call (313) 745-1540. 

For more information on stroke prevention and general health information, please visit our DMC Health Library page at http://www.dmc.org/healthlibrary.

 


 

Dr. Seemant Chaturvedi is Professor of Neurology at Wayne State University School of Medicine and Director of the Wayne State/Detroit Medical Center Comprehensive Stroke Program. He received his undergraduate degree from Princeton University, completed medical school at the University of Connecticut, a neurology residency at the University of Massachusetts Medical Center, and a stroke fellowship at the University of Western Ontario.

Dr. Chaturvedi has co-edited the books Transient Ischemic Attacks in 2004 and Carotid Artery Stenosis: Current and Emerging Treatments in 2005. He was chairman of the American Academy of Neurology carotid endarterectomy guidelines committee, with the guidelines published in 2005. He is currently on the steering committee of several stroke prevention studies. His research interests include carotid revascularization, intracranial atherosclerosis, and stroke in young adults.

 



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Feb 24 2010
Treating Sleep Disorders (part 2) - DRH/HUH

Category DMC Physician Spotlight

0


Dr. Safwan Badr, M.D.
Professor and Chief, Critical Care and Sleep Medicine
DMC Detroit Receiving Hospital (DRH)
DMC Harper University Hospital (HUH)
www.drhuhc.org
www.harperhospital.org

(part 2 of a two-part series)

Last week my colleague, Dr. James Rowley, wrote in this space about the most common sleep disorder, obstructive sleep apnea (OSA).  This week, I’ll write about the ways we have to treat this serious condition.

The treatment recommended for your sleep apnea will depend on the reason for and the severity of the disorder.  If your OSA is from being overweight, weight loss may cause the apnea to go away completely.   Other things you can do are avoid alcohol for at least four hours before going to bed.  If you sleep on your back, use a pillow or some other strategy to force yourself to sleep on your side.  Some people sew a tennis ball into their pajama bottoms to remind them not to turn on their back.

Continuous Positive Airway Pressure (CPAP) is a common device ordered to treat most conditions of OSA.  CPAP is delivered by a compressor that blows air (with or without oxygen) into a mask that is worn snugly over the nose and/or mouth during sleep.  The flow of air acts like a splint to keep the upper airway from collapsing.  This helps prevent obstruction and the apnea from occurring.  The air pressure is adjusted to a setting that best corrects the apnea.  Often a person will notice much less snoring when wearing a CPAP device.

There are devices and surgeries which can be done to treat OSA, for patients who are unable to use the CPAP machine.  Some oral devices (worn in the mouth during sleep) may keep your airway open.  Most of them work by either bringing the jaw forward or keeping the tongue from blocking the throat.  Oral devices are most likely to help a person who has mild sleep apnea and is not overweight.  They are usually custom-made and fitted under the supervision of a specialized dentist or oral surgeon who works with these problems.

The role of surgery in the treatment of sleep apnea is less clear, given the number of possible surgical interventions.  Generally speaking, surgery is less effective than CPAP and is usually reserved for patients who cannot use CPAP.  Surgery can also facilitate the use of nasal CPAP by clearing out nasal narrowing or removing severely enlarged tonsils. 

For more information or to schedule an appointment, call the staff at the Detroit Receiving Hospital Sleep Disorders Center (313) 745-4525.  
 

 
 

 

Dr. Safwan Badr is a leading national expert in sleep disorders who is board certified in internal medicine, pulmonary medicine, critical care medicine and sleep medicine.  Dr. Badr graduated from Damascus University Medical School in Syria and completed his internship and residency in internal medicine at Cook County Hospital, Chicago.  Following two fellowships at the University of Wisconsin, Dr. Badr was named to the school’s faculty.  Since 1996 he has served as the director of the WSU Sleep Program, and in a variety of teaching and administrative positions at the school, including chief, division of pulmonary, allergy, critical care and sleep medicine; professor of physiology; professor of biomedical engineering; and director of the ACGME Sleep Fellowship Program.  Dr. Badr has been the principal investigator on 19 grant-funded research efforts and seven clinical trials.  He holds four patents for biomedical devices. 

 



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The Detroit Medical Center is known for cutting-edge health technology, high quality medical service and expert care. By using social media sites such Facebook, Twitter and YouTube, and creating our own DMC Blog, we hope to extend awareness of our hospital services, top doctors, expert medical treatments and also increase brand awareness to interested persons worldwide.



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