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August 1, 1997     Cape Gazette
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38 - CAPE GAZETTE, Friday, Aug. 1 - Aug. 7, 1997 HEALTH & FITNESS Neurologist joins Orthopaedic Associates By Kerry Kester William Thomas, M.D., a board eligible neurologist, will offer his diagnostic and treatment skills to Orthopaedic Associates when he begins practicing with John Spieker, M.D., and Wilson Choy, M.D. on Sept. 1. Thomas has a particular interest in pain management, particularly as it pertains to the muscu- lar-skeletal system. For example, he said, new treatments are available for back pain, headaches and THOMAS seizure disor- ders, and they've proven success- ful for most patients. Headaches, especially mi- graines, said Thomas, are often under managed. "There are a lot of new treatments for migraines," he said. Multiple sclerosis, he said, is al- so a disease with new treatments available to patients. Beta inter- feron, he said, is a relatively new drug that slows down the rate of the disease's progression. Two other relatively new drugs are also available for inhibiting an inflam- matory reaction, he said. In addition to his interest in muscular-skeletal disorders, Thomas is also interested in treat- ing patients who have not only had strokes but who may be at high risk of becoming stroke vic- tims. "There are a lot of things you can do to prevent stroke," said Thomas. Lowering cholesterol and monitoring blood pressure are the obvious methods of reducing stroke risk, he explained, but there is also prophylactic medication that is available for those who have suffered either "mini strokes" or strokes but remain at high risk to have another one. Mini strokes, known as tran- sient ischemic attacks (TIAs), oc- cur when there is a slight reduc- tion in blood flow to the brain. Stroke symptoms last for only a few minutes, and because the inci- dents are so brief, it is not uncom- mon for people to ignore them. "People who have TIAs really need to see their doctor - any doc- tor - right away," said Thomas. Symptoms that people should rec- ognize as being potentially linked to strokes, he said, are as follows: sudden onset of sensation of numbness or weakness in the arm, face or leg; and occasionally, pa- Prevention proven best treatment for osteoporosis Everyone has heard the adage, "A stitch in time saves nine." Nowhere is that more evident than in healthcare. At Beebe Medical Center, they believe that preven- tion is even better than early treat- ment. Screenings to detect high blood pressure and elevated cholesterol levels have proven to save lives, as have mammograms and pap smears. The Beebe healthcare community would like to see screenings for osteoporosis be- come as widely accepted and used. "Just as we pay attention to the prevention of stroke by bringing the blood pressure down and the prevention of heart attack by bringing cholesterol down, we need to pay attention to the pre- vention of osteoporosis by screen- ing," said Mansour Saberi, M.D. Although osteoporosis does not, in itself, cause death, it does cause fractures, pain, lack of mobility, and even deformity. According to the World Health Organization, osteoporosis affects 30 percent of post-menopausal women around the world. In the United States, 9.4 million women are directly affected by the disease and another 16.8 mil- lion have low bone mass and may be at risk for fracture. The Society for Clinical Densitometry reports that 21 percent of nursing home admissions are because of hip fracture resulting from osteoporo- sis. Over eight million Americans currently have fractures due to os- teoporosis. As the population ages, these figures will rise. The National Osteoporosis Foundation has estimated that the medical cost of treating osteoporosis was $10 billion in 1990, and is predict- ed to reach $30-$45 billion by the year 2020. Osteoporosis is deterioration of bone tissue resulting in reduction tients will experience some nau- sea, vertigo, blurred vision or dif- ficulty swallowing. "Those symptoms need to be heeded immediately - in the emer- gency room," said Thomas. Ex- aminations conducted to deter- mine whether the patient has had a stroke, he said, are through carotid ultrasounds, echo electrocardio- grams (EKGs) or magnetic reso- nance imaging (MRIs). If a stroke has occurred, he ex- plained, patients may have diffi- culty with motor coordination or speech. "Post stroke patients would be best served in a rehabili- tation setting with therapists avail- able," said Thomas, noting that typically the patients work with physical and/or occupational ther- apists. Sometimes, people may have seizure disorders. "People pre- senting with seizures can have ei- ther grand mal or can have a type of seizure that may present with more subtle symptoms such as blurry vision and periodic spells of loss of attention, headaches, ringing in the ears, staring spells, and a long history of other symp- toms," said Thomas. "It takes a neurologist, I think, to determine a complex seizure disorder," he said. Seizures, too, he explained, are often difficult for physicians who do not special- ize in neurology to manage. "There are new drugs that have been developed for seizures that are refractory for previous seizure treatments," said Thomas. Basi- cally, he said, "If patients haven't been to their primary care doctor and are having symptoms - numb- ness or tingling - they may be hav- Continued on page 41 Radiologic Technologist Brett Kuhlman administers a dosimetry test for osteoporosis at Beebe Medical Center, of bone mass. The human skele- ton constantly replenishes and re- pairs itself until adulthood. According to Saberi, puberty is the time of peak bone mass. "Af- ter age 25, your bone mass is go- ing to decline gradually. When women begin menopause, that bone loss accelerates," he said. Post menopausal osteoporosis affects the entire skeleton. In early Continued on page 40 Skin takes a beating in sporting activities People who participate in sports develop disciplined, well-condi- tioned bodies. The American Academy of Dermatology main- tains that a body that is in good shape is more effective at pump- ing blood, and at carrying oxygen and other nutrients to the skin and other organs. A healthy body is al- so better at resisting colds, flu viruses and other illnesses. However, in addition to these rewards, there are sometimes un- expected injuries due to participa- tion in sports. Beebe Medical Center dermatologist Mitchell Stickler, M.D. says, "Because it is the single largest organ in the body, your skin really takes a beating, whether in the gym, the pool, the courts or out on the play- ing field. The friction of rubbing and the sweat from intense com- petition are the primary causes of the many skin problems generated in sports." Strickler suggests the following precautions: Baseball, golf and tennis play- ers are at greater risk for getting sunburned. Several bad sunburns when young may predispose a person to skin cancer and wrin- kling in 10 to 20 years. Remember to wear a sunscreen with an SPF of at least 15, especially between the hours of 10 a.m. and 3 p.m. It is important to know that achiev- ing a tanned look is a process which damages the skin. Tanning is what the skin does in response to the injury that occurs when the skin is exposed to sunlight. Tan- ning is a social disease, like ex- cessive drinking of alcohol and smoking cigarettes. Black heel or palm can occur to participants in these sports. The injured skin becomes discolored in a spot where skin has been re- peatedly pressured to slide side- ways, causing tiny veins in the skin to break open and bleed into the skin. This injury should be al- lowed to heal naturally. Tennis toe or jogger's toe hap- pens when the big toe bumps up against the shoe and bleeding un- derneath the nail results. This con- dition can be prevented by wear- ing properly-fitted shoes which are high enough so that the toe can be curled or bent comfortably. Soak a toe injured this way in warm water and give the feet a rest. Track runners and basketball players are at risk of 'Runner's Rump.' Round, purplish spots and darkened skin develops on the up- per middle part of the buttocks and appears when the skin is con- stantly rubbing against itself dur- ing long period of running. This condition vanishes when the level of running is decreased. Corns are round knobs of tough skin that form over foot bones which protrude. Shoes which are too narrow contribute to this. If it is painful, see a physi- cian for treatment. Calluses are caused by contin- ued friction or pressure on any part of the skin which comes in contact with athletic equipment. Because feet carry all of a per- son's body weight, they are par- ticularly susceptible to calluses. While gymnasts may feel hand calluses are an advantage, golfers and tennis players can prevent them by wearing tight-fitting ven- tilated gloves. Calluses should heal naturally when left alone, but if they be- come annoying, soak the affected area until soft and rub off the up- per skin layer with a pumice stone. Continued on page 40 HEALTH TOPICS MITCHELL STICKLER, M.D Mitchell Stickler, M.D., is a dermatologist whose practice is located in Lewes.