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January 4, 2005     Cape Gazette
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January 4, 2005

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18 - CAPE GAZETTE, Tuesday, Jan. 4 - Jan. 6, 2005 HEALTH & FITNESS New physician specializes-in joint replacements Carroll joins Lewes orthopaedic practice By Henry J. Evans Jr. Before he became a doctor he was an engineer, and his knowl- edge gained from working in that profession's discipline have given him an advantage in current work as a joint specialist. Dr. Edmund T. Carroll II1 has brought his expertise in hip and "knee joint-replacement surgery to Orthopaedic Associates of South- em Delavare in Lewes. A native of Bucks County, Pa., Carroll took his first degree from Rochester Institute of Technology in packaging engineering. However, he said the field did- n't have the hands-on people con- tact he wanted in a profession. After working as an engineer for about three years, he decided to go to medical school, following in the footsteps of his father who is also a doctor. Carroll said he became interest- ed in working exclusively with knee and hip joint replacement during his residency training in 2000. "Patients would come into the office barely walking, and then six weeks later they'd be pain free and returning to their normal ac- Henry J. Evans Jr. photo Dr. Edmund T. Carroll III recently joined the practice of Orthopaedic Associates of Southern Delaware in Lewes. Carroll brings his expertise in hip and knee joint-replace- ment surgery to this area after last practicing in Largo, Fla. He received his speciality training at the Univeristy of Chicago Bone and Joint Replacement Center. tivities of daily living," Carroll said. A graduate of the Frankford Hospital System in Philadelphia, Carroll did his fellowship training at the University of Chicago Bone and Joint Replacement Center in Chicagor "Every orthopaedic surgeon is trained to do hip and knee re- . placement surgery. It's the degree of difficulty of the replacement that comes into question," he said. Carroll said that's what the fel- lowship, or specialty training, is about. "You'll have a generalist per- form a procedure they think is run-of-the-mill, and they may run into trouble, vs. a specialist where it's all preoperative planning and having your back-up plans avail- able to successfully perform the procedure," he said. He said another part of his prac- tice, called revision, involves cor- recting problems that have devel- oped with hip or knee replace- ments that have gone wrong. "It could be because of traumat- ic or infection reasons the pros- thesis becomes loose and the sur- gery needs to be done again," Car- roll said. He said hip and knee replace- ment techniques are always evolving with new methods and materials being introduced. He said unfortunately, some types of hip and knee joint-re- placement surgery, such as the mi- ni-incision technique, have be- come something of a marketing tool. "It's not for everyone and it shouldn't be used in that manner," he said of the mini-incision. At the core of hip and knee joint re- placement is the prosthesis, the ar- tificial joint, or what surgeons call the articulation that is inserted in place of the problematic bone structure. Carroll's engineering experi- ence provides him with a high level of comfort in understanding and working with a variety of high-tech materials he uses in joint replacement. "Today, we're just tinkering with metal-ceramics, and then there's the conventional polyeth- ylene-metal and the highly cross linked prlyethylene-metal. I lean toward the metal-on-metal articu- lations," Carroll said, discussing the various advantages of the ma- terials used in joirit replacements. He said he's performed nearly 1,000 procedures where the mt- " el-on-metal prosthesis was used. But to a large extent, Carroll said the prosthesis a patient will get depends upon the lifestyle they lead. "Demand matching allows me to choose the correct prosthesis for a patient," Carroll said. He said that demand-matching fac- tors include things such as the lev- el of insurance coverage, the hos- pital used and patient's lifestyle in working to keep the cost of per- forming joint surgery as low as possible. "You can be 60 years old with an arthritic hip but have been ex- tremely active and you're physi- cally fit with good bone quality. Then I'm going to put in a pros- thesis that's going to give you the longest wear," he said. Carroll holds a doctorate of os- Continued on page 19 Simple stepsmake 00:eeping exercise resolution easier The beginning of the year is a time for new year's resolutions. 'q am going to start to exercise" is a common new year's resolution. However, by February, most peo- ple have given up on their exer- cise program. Here are a few tips to improve your chances for suc- cess. Exercise is important for all ages. No matter what your age, the benefits of exercise are the same- increased energy and self- esteem, conditioned heart and lungs, improved muscle tone, and greater function of the bones and joints. Engaging in regular exer- cise can also reduce the effects of certain chronic diseases, such as diabetes, high blood pressure, arthritis and osteoporosis. Warming up by doing light movements and jogging in place prepares you for exercise by in- creasing the oxygen supply to your muscles. Five minutes of warming up be- fore exercise can help reduce your risk of injury during exercises. Marching in place is a great warm-up. Ten minutes of gentle stretching can help improve flexibility in your muscles and joints. Flexible HEALTH TOPICS Care Konlian Care Konlian, MSPT, is the clinical director and owner of Aquacare Rehab Services Inc., a physical therapy prac- tice in Easton, Md.; Salis- bury, Md.; and Lewes. For more information, call 945- 0200. muscles and joints are less prone to injury. As you stretch, avoid bouncing, which can strain mus- cles. Pay special attention to ar- eas of the body that are prone to tightness, including the shoulders, chest, hamstrings, calves and hips. Aerobic exercise is a key part of a balanced exercise plan. Exer- cises like cycling, brisk walking, swimming and jumping rope can help condition your entire body. When done for at least 20 to 30 minutes, aerobics can help you body use oxygen more efficiently which can help condition your heart and lungs. Strengthening exercises are de- signed to increase muscle tone. Strengthening may begin with us- ing the weight of you own ann or leg. Leg strengthening might be- gin with standing at the kitchen counter and rolling up and down from heels to toes or lifting a leg out to the side. A starting point may be only three to five repeti- tions. Once weight has increased to ten repetitions without fatigue or residual soreness, weight or re- sistance can be used. A can of soup can be used. A variety of ex- ercises can be done with elastic bands or tubing that comes in dif- ferent resistance. Cooling down allow s your heart rate to ease back to normal. You can cool down, by walking at a normal pace for about five min- utes or by doing gentle stretches. Walking is a great way to achieve overall fitness year- round. It strengthens your cardio- vascular system, tones and lim- bers up you muscles and burns off unwanted calories. Walking at a brisk pace gives you the same aerobic benefits as jogging. During the first week, walk 10 to 15 minutes at a slow pace. Stay on a flat surface; avoid hills and stairs. After a week, maintain the same distance but pick up the pace. Over the next several weeks, build up gradually to a 20-to 30- minute Walk, three to four times weekly, at a pace that is brisk but comfortable. You should be able to walk and talk at the same time, but be slightly out of breath. Exercising in the water is a great way to improve fitness and overall well-being. In most cases, you don't even have to know how to swim. Because of the body's buoyan- cy in the water, a water exercise program greatly decreases strain on your joints and muscles. If you have not been exercising on a regular basis, always obtain medical clearance from your physician before beginning an ex- ercise program. In fact, with a physician's ap- proval you may be able to proceed even if you have a serious health condition, such as heart disease, hypertension, diabetes or arthritis. You should put your program on hold if you experience a rapid onset illness - particularly if it in- volves a fever - unstable chest pain, uncontrolled diabetes, asth- ma or hypertension, congestive heart failure, or if you are being treated for hernias, cataracts, reti- nal bleeding or joint injuries. The following are some tips to help stay motivated with your ex- ercise program: exercise with a buddy; consult with a personal fit- ness trainer or physical therapist; incorporate exercises into short sessions throughout the day; set realistic short-term goals - losing 50 pounds may take some time, so set a goal that you will be able to achieve in a shorter period of time; integrate exercise into your life - find ways to combine exer- cise with family activities, during social times with friends or during lunchtime. Once you have made your com- mitment to exercise you will feel better both physically and mental- ly. What are you waiting for?