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Dr David Hartman on Head Injuries

 
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Q&A: Dr David Hartman on Head Injuries (824 Posts)
Topic Comment
"might be broken"
On 3/17/2004 herbn wrote in from (152.163.nnn.nnn)

it's a tough call,if you wait to long ,it could set wrong. Look for an actual physical change in shape/ conture of the body part in question. The free clinics sound interesting. There are places that just do imagining(x rays ect) they're supposed to be much cheaper than hospitols.

 
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Free LA Clinics
On 3/16/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

halfbreed,

First there are probably city hospitals which will treat you if you are a resident. Call and ask. Otherwise, look into these.

Free Clinics in LA
The Los Angeles Free Clinic
o Beverly Clinic
8405 Beverly Blvd.
Los Angeles, CA 90048
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
o Hollywood Center
6043 Hollywood Blvd.
Los Angeles, CA 90028
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
o Hollywood Wilshire
Health Center
5205 Melrose Avenue
Los Angeles, CA 90038
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
Los Angeles Mission Community Clinic
Monday through Thursday, from 7:00 AM until 4:00 PM
Call for appointment
(213) 893-1960
303 East 5th St.
Los Angeles, CA 90013
Health Care Free of Charge to All In Need
General adult medical care, TB screening and prophylaxis, Health screening (including diabetes,
blood pressure, cholesterol), Cancer screening (including cervical, breast, colon and prostate),
Sexually transmitted disease screening and treatment, Dental care - both on-site and by referral,
Chiropractic care, Subspecialty clinic referrals, HIV prevention classes held twice a week at the
clinic, Confidential and anonymous HIV counseling and testing, Spiritual counseling for those
living with HIV and AIDS, HIV-specific referrals for housing and medical care.
Website: http://losangelesmission.org/about/lamcc.html

2
Arroyo Vista CHC (AVFHC-Highland Park)
Locations:
o 6000 North Figueroa Street, LA, CA 90042
o Lincoln Heights, 2221 North Broadway, LA, CA 90031
o El Sereno, 4815 East Valley Blvd., LA, CA 90032
o Estrada Courts, 1305 S. Concord, Unit 12, LA, CA 90012
o Ramona Gardens, 1424 Crusado Lane, U#168, LA, CA 90033
o William Mead, 268 Bloom Street, U#322, LA, CA 90012
(323) 254-5291
prenatal, pediatrics, adolescents, adult medicine (including women?s health), and geriatric
medicine. Specialty and ancillary services such as dermatology, podiatry, dental, optometry,
laboratory, radiology, ultrasound, mammograms, pharmaceutical, and health promotion and
disease prevention are also provided. Free on-going health screenings, annual adult and
children?s health fairs, and regularly scheduled health education classes are provided.
Web Site: www.arroyovista.org
Chinatown Service Center Family Health Clinic
Alpine Tower
767 North Hill Street
2nd Floor, Suite 200
Los Angeles, CA 90012
(213) 808-1718.
Monday - Friday 8:30 am - 5:30 pm
Saturday 8:30 am - 12:30 pm
Closed on Sunday and other public holidays
All services are low-cost to free depending on income level.
Primary family health care, women?s health care, men?s health care, and senior health care.
Clinica Msr. Oscar A. Romero
123 South Alvarado Street, LA, CA 90057
(213) 989-7700
318 South Alvarado Street, LA, CA 90057
2032 Marengo Street, LA, 90033
(323) 987-1030
Free medicines, Pediatrics, prenatal, post-partum care and family planning,
Chronic Disease Management, including but not limited to diabetes, asthma and hypertension,
Immunizations, Cancer screening, Health Education and Prevention,
Limited specialty care such as cardiology and ophthalmology,
Emotional support groups and one to one counseling and mental health services,
Leadership training and neighborhood organizing around quality of life issues
Website: http://www.clinicaromero.com/
Hollywood Sunset Free Clinic
3324 Sunset Blvd, LA, CA
(323)660-7959
Free medical and counseling services residents of Echo Park, Silverlake, East Hollywood and
downtown communities of Los Angeles. Services include tattoo removal, primary care for
children and adults, mammogram screening, HIV/AIDS services, and counseling.
Website: http://www.hollywoodsunsetfreeclinic.org/

3
Northeast Community Clinic
o 5809 N. Figueroa St.
(323) 256-3884
o 1810 S. Fair Oaks, Suite 300
South Pasadena, CA 91030
(626) 403-8080
Children?s Health and immunizations
QueensCare Family Clinic
o Hollywood (323) 953-7170: 4618 Fountain Avenue, LA, CA 90029
o Echo Park (213) 380-7298: 150 North Reno Street, LA, CA 90026
o Wilshire District (213) 368-9779: 3242 West 8th Street, LA, CA 90005
o East Los Angeles (323) 981-1660: 133 North Sunol Street, LA, CA 90063
o Eagle Rock (323) 344-5233: 4448 York Boulevard, LA, CA 90041
Monday-Friday 9am to 6 pm
Care for all patients regardless of ability to pay.

 
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no health insurance
On 3/16/2004 halfbreed wrote in from (63.198.nnn.nnn)

well about 5 days ago i fell and im pretty shure i broke my hand right before the first joint of my left hand. im wondering if doctors can do any thing for it if its broken, and is it worth geting checked out. more importantly im wondering if you know of any place in los angeles where a person like me (with no insurance that is)can go to get free or cheep health care with out having to go to county. and if i do have to go to county what is the drill on going there?


 
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The Stink about MSM
On 3/12/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

Hey Lands-End, Welcome! Glad this site is helpful to you. There's a mixed answer to your question: Glucosamine/Chondroitin is pretty well supported for helping joints heal. There's some good medical literature out there and I think it's worth using. MSM is another matter. MSM is a sulfer-compound similar to DMSO. It may work to reduce inflammation from the available sulfur, but nobody really knows if and how it works. It was originally used as a horse balm if that's any help. There's nothing good in the medical literature and if you are allergic to sulfur-containing compounds DO NOT try it. I don't think there's any synergistic benefit from using G/C and MSM together. Anyway, except if you are allergic, it doesn't seem to be toxic, and if you think it helps, there doesn't seem to be any reason to stop using it. Lukewarm recommendation? Yeah, but if I can't find the research or science to back it up, I'm not going to fall over backwards recommending it.

Readers, have you tried MSM? What was your experience with it?

sk8on DrDH

 
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Glucosamine Chondroitin and MSM
On 3/11/2004 lands-end wrote in from (208.200.nnn.nnn)

Hello all,
I am re-habbing a ruptered achilles and noticed the glucosamine comments a page or so back, I can definetely say this has helped me heal quicker from my surgery and has eliminated my back and shoulder pains as well(these have been ongoing). The brands of this I used that seemed to work the best for me were the ones that have MSM in them. Dr Dave do you have any opinions about MSM and GC?
Snoball: FYI my 92 year old Grandpa and 91 year old Grandma both take this,have had no issues and both love what it has done for them. May be great for your Dad, check it out, it might really help.

 
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those seats, endo balence boards.............
On 3/4/2004 herbn wrote in from (152.163.nnn.nnn)

Endo balence boards are cool, you could make one pretty easy,i cound make a really nice v lam fiberglassed flexy camber or rocker endo in a snap,i probabely will, but if your not a crafter and you're in need of ankle/hip knee rehabthey seem to be doing the trick, just buy one. As always, you gotto know your body,this type of thing could easily do damage if you get on it to early. I would say ,if you "need" pain killers you are probabely pre habing except of the lightest stretching,if your not sure see your doctor...... and gel seats ,Pa leez. Those holey seats where sort of a fad,i had one for a short little while... and i have some theorys. Different people may have that particular nerve in a more perilous location,a fraction of an inch one way or the other may make the difference.Pressure on that nerve could be measured in pounds per square inch, a heavier person puts more pounds on an area on seats that's maybe one square inch. I BMXed everywhere as a kid and even had a short stint of roadbiking back then, skipped out for maybe two or three years and started mountainbiking when no one had suspension. If i havn't had thee nerve problem (and all the msherbns have never complained) and the nerve problem is not happening now either,so it won't.Right now the last hilly 30 miles i did felt like 60m, but a day off and i'm jonsing to get out tommorrow at dawn, and check some of my skating hills out for wintery damage,to be skated at a future time.

 
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herbn progresses by the seat of his pants
On 3/1/2004 Dr. Dave wrote in from (68.74.nnn.nnn)

Hey guy,

Glad to know you are out and about, but get the ankle weakness checked out by your family doc or a neurologist and think about a sports podiatrist. If your ankle is not at the correct angle it's going to cause you more trouble down the road. Two other suggestions: They make wide, gel seats for bikes, which are much better for not inflaming nerves. Make sure you get one with the "split" in the middle, so as not to irritate the nerves from that other part of your anatomy that mrs. herbn values so much.

Also, cycle shorts come with gel pads. They look dorky but let you ride in comfort. Heal up and feel better.

DrDH

 
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syatic type nerve damage /or pinch
On 2/29/2004 herbn wrote in from (64.12.nnn.nnn)

well it's been 4 and a half weeks and i just did a 20 mile bike ride with a steep climb at the end,pretty good sorry to talk biking on a skate page but i don't think anybody thinks skating is a recovery activity, bike to recover, to skate again. There is still a point of impact sore spot that is under presure while sitting on wide seats, my 16 lb road bike does not have a wide seat. I use foam called egg crate on my car seat and at my store. My ankle seems a bit weak mostly in the "toe lift" direction but a bit in the side to side direction too. I'm thinking it might mostly be the sprain that occured when the ankle was at it's weakest from the nerve pinch, and it will take it's time healing, but it will be "100%" again. I'm ordering some balence boards, for my shop and to use for rehab. I've got some ideas for vacuum molding a carbon ankle brace for freeride /mt biking addictions, i'm not going off road til i'm healed enough to ride four hours on the road. One more thing i'm always gonna use my DH body armor and make an extension on the bottom edge of the plastic spine guard,it'll hang ,like a bit of a trench coat(behind the seat), but it'll be there should i land on my butt. I'll use this armor even for skating ramps(i may avoid skatelite all together), maybe even hills.I've reached the(obvious) conclusion that as you get older, time is more precious, and injuries that keep you for doing the things you love are more and more tragic, i may hold back just a bit from really agressive stunts or maybe just not search them out as much.

 
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less drugs
On 2/26/2004 herbn wrote in from (205.188.nnn.nnn)

yeah i know,sometimes i feel like an addictive personallity but with a back up overide. I've taken this stuff in the past for a couple of nasty injuries and as soon as things were better, no craving. I have less and less confidence in judging the duration of this injury,baby steps. When i feel a substantial improvement occurs it usually ends up being sort of a residual effect of the pain killer, like i don't really feel it in my head but it's still working, could be a lingering anti inflamitory effectm,oh well. I am being careful not to over do things when i'm "feeling good" i think i'll be able to bike again pretty soon, just low impact roadriding and i think at that point natural healing will kick in, or at least i have something that keeps me positive and able to track progress in a meaningful way.It's been 4 weeks and 1 day, and 6 hours since "big pain day" i still feel that any day now i could wake up with a much better situation. Accupucture has been suggested a friend who skated and now mountainbikes has had good luck with it.

 
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Quick Watson. . . .the needle. . . .
On 2/25/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

Hey herb n

Ever think of going to a sports podiatrist for those ankles? You may need orthotics or supports that adjust your pronation. These guys are good. Check 'em out.

'Watson' is likely the mfgr's name for hydrocodone (narcotic) possibly with tylenol. "Soma" is Carisoprodol® is a muscle relaxant, used to treat the pain and stiffness of muscle injuries, including strains, sprains and muscle spasms.

Not surprising that "Watson" kicks like a mule. . .being a narcotic, it's addictive, tolerance producing and if you drive or skate with it and they find it in your system, youse in big trouble. . .as they say on the South Side of Chicago.

Some non-drug ways to reduce chronic pain include TNS - a nerve stimulator, which buzzes the nerves with a low level electrical pulse and confuses the pain gates, or acupuncture, which works for whatever reason acupuncture works.

Try to avoid the big advil habit. That class of over the counter med is good for causing stomach pain, bleeding, etc.

DrDH

 
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advil
On 2/25/2004 herbn wrote in from (64.12.nnn.nnn)

how much? the package says a max of 6 a day, unless directed by a doctor. I have some "unofficial" meds called;soma and and a thin little tablet with "watson" written on the side,watson is a somewhat famous manufacturer of qualudes but that's not what these are , they have considerably more effect than "advil" or the 10mg "cyclobenzaprine" my dr prescribed. Normally i think drugs are really stupid,but pain like this makes me a pharmaceutical enthusiast,i don't think i'd get adicted ,natural adrenalin and natural endorphines are by my favorite.

 
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taping ankles
On 2/25/2004 herbn wrote in from (64.12.nnn.nnn)

while my nerve pinch/deep mucsle bruise was at its worse i managed to roll the ankle. The muscles that pull the front of the foot up,and of course the heal downwards,are quite weak.This ankle has been a bit thicker than the other one, when i think back,it was in a cast once a long long time ago,and a bit tweeked several years ago in a snowboarding tumble where the stresses at one point tried to pull my foot out of the boot. This symtom has been with me for a long time,i just dug up an old pair of shoes and find that the wear on the shoes to be different, the left shoe has normal healwear the right is worn a bit flatter.Generally my knees and ankles have been very strong and generally don't get hurt much(as i stop typing to knock on something wooden)I thought of an old Natas Kaupas interview where he talks about skating with badly sprained ankle by taping over his sock with duct tape and just cutting the sock off at night. It seems like i can exercise the muscles by pulling up against the tape,and it keeps my ankle in a more toes up position.

 
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If it ain't broke, don't massage it. . .
On 2/21/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

herbn,

You know the old joke about the guy who goes to the doc and raises his arms above his head and waves them and says 'It hurts when I do this." Doc imitates him and says. . .'well, don't do this!' (Ba-DUM! -cymbal crash here. . .)

O.K. seriously, unless you are really having pain putting weight on it, it's probably just part o' the bruise, either nerve or bone. Takes a while to heal but you are noticing that it does recede over time. It hurts most in the night and early morning becaues your natural painkilling endorphins are low during that time and because you are not distracted by anything else. You could see if a motrin or a tylenol helps. A little applied Ben Gay or capsaicin could also confuse your pain receptors (don't apply anywhere near the family jewels or more than your pain receptors will be confused). If your pain is in both hips, tell your doc at your next visit and see if he'll throw an x-ray your way. Injuries to joints can cause arthritic changes later, so that's also something to watch out for. Keep us posted.

DrDH

 
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deep bruises
On 2/20/2004 herbn wrote in from (205.188.nnn.nnn)

question doc, i'm not seeing any external /visable bruising or swelling, nothing. All i can find is when i do sort of a deeper massaging is way in by the bones there are edges of my hip bones that are sore. and oddly enough half way between my knee and ankle on the outside of my leg, this spot kind of has a felling that's half itching and half stabbing and it gets worse at night particularly when i'm tring to sleep,Is this some kind of nerve junction point? . The painful areas are getting smaller and less intense.

 
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pads for those hippers
On 2/20/2004 herbn wrote in from (205.188.nnn.nnn)

i've got plans; ok,the padded riding pants i got as mountainbiking underwear are for sure m,but i'm thinking of having a couple pockets added, in strategic places, to a pair of jeans, and then making some 1/8 inch sheets of UHMW (like recaps)that fit in those pockets.

 
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Injuries r us
On 2/19/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

herbn,

Glad your sciatica is getting better. Nerves don't like those deep bruises. Pads next time? O.K? I'm up for people writing in with things that have worked for their board injuries, but as you say, no liability and the guy who writes in with a handle like "Three6pakJack" is not likely to be a reliable source of medical information. But, if it helped you, put it here.

DrD

 
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this page
On 2/18/2004 herbn wrote in from (152.163.nnn.nnn)

this page could be like a self fix page, or maybe a way to evaluate your own injurys, by comparing them to posts of other skaters who injuried themselves in similar ways, for instance very few doctors would know the stresses of a "aciddrop sweeper"(jumping to far down the tranny)anyway some sort of liability waiver is both understood and could be in the intro to the page,oviously dangerous self treatments would be deleted like inflammetory angry cussing posts.It'd would be interesting to see how extreme/committed people can get for the purpose of preventing or curing injuries.For instance," by the book" treatment of road rash,makes it heal so fast it's almost unbelievable, but it's nearly a full time job,removing soft clotted blood injuries every 4 hours (or so) while reappling baccitration and fresh dressing.

 
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herbns "sciatica"
On 2/17/2004 herbn wrote in from (205.188.nnn.nnn)

well it's been three weeks(sunday night)and i'm quite a bit better. The center of the injury,(pt of origin)was a deep bone bruise on my pelvis.I landed on my butt on a slid out ollie(damn you skatelite,damn you to hell)this was a couple minutes before the sweeper landing near flatbottom gave me the back spasm that ended the session and two days before a bike riding and snow shovelling inflame the sciatic nerve(bundle?)so it wasn't the sweeper by it's self.A bit of a weak steroid cycle and a wimpy pain killer was all i got from my MD,but stronger pain killers ,a muscle relaxent and even a little cortizone injection (in the effected area),from an "other source" did considerably more. Complete rest being the most beneficial ,is not always possible/affordable,laying in bed with meals and "bathrooms" being brought to you is one extreme, how close you can get to this hospitol type situation does alot to how quickly healing happens.Sundays in bed ;starting saturday night and going well into monday morning, brought about a lot of improvement.I just looked up at the top of the page, is this suppoesed to be about only head injuries,just call the page "Wear a Helmet" ? Oh well , the weather is still winter(suck) on the cusp of spring,we could have a wintery relapse, but it is warming. I hope to be back in good form in like 3 more weeks. I'm taking some nutritional stuff too;glucosamin,calcium,and trying to eat a bit less of everything else to not gain weight. I have a few little intuitive rehabs; lifting toes off the ground(pivoting on heal) balencing on one foot,clenching toes. I think when i get back on my (road)bike that will but in the final touchs, that with maybe a bit of a concentration on a machine at the gym that works the abductors,along with my usual crunches and back extensions.

 
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Herbn's Sciatica (pscilent first c)
On 1/31/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

Herbn

It's important to know that sciatica is not a disease - it's a type of nerve damage to the (insert 'duh' here) sciatic nerve. Sciatica is a form of peripheral neuropathy. It occurs when there is damage to the sciatic nerve, located in the back of the leg. This nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg and the sole of the foot. Incomplete damage to the sciatic nerve may appear identical to damage to one of the branches of the sciatic nerve (tibial nerve dysfunction or common peroneal nerve dysfunction).

A problem in a single nerve group, such as the sciatic nerve, is classified as a mononeuropathy. The usual causes are direct trauma (often due to an injection into the buttocks), prolonged external pressure on the nerve, and pressure on the nerve from nearby body structures. It can also be caused by entrapment -- pressure on the nerve where it passes through a narrow structure. The damage slows or prevents conduction of impulses through the nerve.

The sciatic nerve is commonly injured by fractures of the pelvis, gunshot wounds, or other trauma to the buttocks or thigh. Prolonged sitting or lying with pressure on the buttocks may also injure it. Systemic diseases, such as diabetes, can typically damage many different nerves, including the sciatic nerve. The sciatic nerve may also be harmed by pressure from masses such as a tumor or abscess, or by bleeding in the pelvis. In many cases, no cause can be identified but a ruptured lumbar disk in the spine may cause symptoms that simulate the symptoms of sciatic nerve dysfunction.

Sciatica Symptoms & Signs include:

Sensation changes on the back of the calf or the sole of the foot
Numbness, decreased sensation, Tingling, burning sensation
Pain, may be severe, Abnormal sensations, Weakness of the knee or foot
Difficulty walking, Inability to move the foot (in severe cases)
Inability to bend the knee (in severe cases), Sciatica might be revealed by a neuromuscular examination of the legs by a physician. There may be weakness of knee bending of foot movement, or difficulty bending the foot inward or down. Reflexes may be abnormal, with weak or absent ankle-jerk reflex.

Tests that reveal sciatic nerve dysfunction may include:
EMG (a recording of electrical activity in muscles)
Nerve conduction tests and other tests are guided by the suspected cause of the dysfunction, as suggested by the history, symptoms, and pattern of symptom development. They may include various blood tests, X-rays, MRIs, or other tests and procedures.

Sciatica reatment is aimed at maximizing mobility and independence. The cause of the nerve dysfunction should be identified and treated as appropriate. In some cases, no treatment is required and recovery is spontaneous.

Conservative treatment is usually appropriate if there was sudden onset, minimal sensation changes, no difficulty in movement, no history of trauma to the area, and no evidence on testing of degeneration of the nerve axon.

Surgical removal of lesions that press on the nerve may help in some cases. In cases of severe injury to the nerve, such as laceration, recovery may be not possible or may be limited.

Over-the-counter or prescription analgesics may be needed to control nerve pain.

Various other medications may reduce the stabbing pains that some people experience, including phenytoin, carbamazepine, or tricyclic antidepressants such as amitriptyline. Steroids may help with nerve inflammation related to a herniated disc. Whenever possible, their use should be avoided or minimized to reduce the risk of medication side effects.

Physical therapy exercises may be appropriate for some people to maintain muscle strength.

The use of braces, splints, orthopedic shoes or other appliances may help to compensate for lost or impaired function.

The information above can be seen, with pictures from www.allrefer.com

Hope it's helpful. DrDH

 
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syatica(sp?)
On 1/29/2004 herbn wrote in from (205.188.nnn.nnn)

tell me about different degrees of severity,treatment, and recovery times?, this sucks

 
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Love That Bob
On 1/25/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

What an offer! Just to be clear for Bob, this will NOT help shoulder dislocations or tendon tears. But if you had a bad break and your ortho doc O.K.'s it, talk to Bob. 20 karma points for the next skating lifetime, Buddy.
DRDH

 
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Bone Healing
On 1/22/2004 Bob Swartz wrote in from (132.250.nnn.nnn)

When I broke my leg with a long spiral frature to my my right Tibia during an event I was told that I was going to have a minimum 16 week recovery. As a world cup competitor and avid researcher I could not just simply accept what my local Orthopedic Doc had to say. Especially when she told me to stop doing what I was doing. I figured she had no idea about why and what makes people want to compete and how to help me get back to it, even though I insisted on the fact that I would do anything to rehabilitate faster.
I decided to search the net for more info and found out that the Head of the Team Doctors for the Baltimore Ravens and Dean of Orthopedic Surgery and Sports Medicine at the University of Maryland took appointments fom common folk like me once a week. I made the appointment with him and in a 30 minute visit felt hopeful and upbeat about REAL sport medicine. He told me that the 16 week thing was conservative medicine. He told me that he could most likely accelerate my recovery but %20 if I am able to follow his plan after all he gets paid the big bucks to do this for high paid ball players wanting to be back in play.
He prescribed a external Bone Stimulator from EBI and helped word the prescription such that insurance would cover the bulk of the cost. He also gave me a few diet tips and some limited exercises and temperature change treatments I could do with my leg in the full cast. Well needless to say my local ortho doctor was surprised at the bone growth and healing. especially since I did not tell her about the other DOC and how I wore the Bone Stim for 10 hours a day. Anyway I was down to a boot type cast after 9 weeks and racing at 10 weeks with my own modifications. Just incase, I elected to race Hot Heels and the Gravity Games with an aircast inside a boot to protect it.

Oops didnt mean to tell life story.. the reason I post here is that I have this $4000. bone stimulator sitting under my desk collecting dust and thought that it may help someone else out that was not so fortunate withthe insurance coverage. So if you have bone healing problems ask your Doctor if this EBI Bone Stimulator will help and maybe we can make a deal. Remember, Only if the Doc says so..

Here is the info on this unit
http://www.ebimedical.com/products/fracture/bonehealing.html

Let me know

bob

 
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Vacation
On 1/17/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

Short vacation, people, gone from Sunday Jan 19th to Sun 26th. Leave questions, I'll catch them after that. Thanks!

Best,

Dr. Dave

 
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ACL, MCL
On 1/16/2004 MissouriMatt wrote in from (128.206.nnn.nnn)

Jason,
I'm rehabing from ACL replacement. They didn't do the MCL because there was a hair left. I'm still waiting for that to tighten up. I tore it mid June and had the ACL replacment in late July. There are ALOT of good exercises to do at home. Access to a gym will broaden what you can do as well. But no matter what they tell you about mussel mass, nothing beats some good ligaments for joint support. If you are young I wouldn't back away from surgury if you can swing it. You can e-mail me on some payment plans/programs if insurance won't cover. Make sure you have a good surgeon.

I just had another MRI to assess the MCL progress. I may see the knife again, but we are not moving quickly toward that. Rehab is really tough when you’re working against a week joint and are wearing a brace everyday. The Doctor that did my ACL is well respected and does about 180 ACL’s a year. He’s helped develop a couple of the tools used by many surgeons currently doing the patellar grafts. He did my right knee back in 1991 and it’s been great, but the week MCL has really slowed progress this time around. I saw him this week and he was scratching his head on the swelling… I tell you more when I see him again. Boy, skaters with injuries really can ramble… I haven’t skated since the big crunch and I’m getting a little stir crazy. I do my squats and other exercises while standing on my board.

Good luck and stay on the home/gym rehab. The internet is no place to get instructions on rehab, but those tedious quad sets and leg lifts are important. Sitting in a rolling chair and “pulling” yourself around feet forward is a good ham workout. Squats against the wall are good, or sit in a chair, put a medium rubber ball between your knees, squeeze hard, stand half way up, hold the squat, sit, relax, repeat. E-mail me if you kneed to bitch about instability.

Good luck. I’m almost the big 40 and it’s sucking being off the skate for 8+ months!!! If things don’t look like they’ll get better soon, I’ll go to easy skating in the brace and see how far I can take it. I’m afraid the days of aggressive park skating are only in the pictures, but I’ll skate.

Ride on…

Matt Gaunt

 
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SketchmasterBruiser
On 1/15/2004 Dr. Dave wrote in from (24.13.nnn.nnn)

Sketchmaster,

Bruising occurs after traumatic injury and consists of swelling and discoloration under the skin but no disruption of the skin. Bruising is a normal body response to trauma. However, when bruising occurs often and from very minor and sometimes unnoticed trauma and/or if you have a disorder or a medication that interferes with blood clotting that bruising may indicate something more serious (such as a blood-clotting problem or blood-related disease). Conditions such as liver or kidney disease; blood disorders, such as hemophilia, platelet dysfunction, thrombocytopenia, leukemia, and multiple myeloma; connective tissue disorders including scurvy, Marfan?s syndrome, and Ehlers-Danlos syndrome; or the use of blood-thinning medication, such as aspirin and warfarin (Coumadin), should be considered. (Hey, you asked).

To answer your question, see your doctor if:
You have unusually large or painful bruises, particularly if your bruises seem to develop for no known reason.
You're bruising easily and you're experiencing abnormal bleeding elsewhere, such as from your nose, ears, gums or intestines.
You have no history of bruising but suddenly experience bruises, particularly if you recently started a new medication.
If you have a traumatic injury and there is organ or bone injury, in addition to bruising.

You can't do much to treat minor bruises, although a cold compress may help reduce swelling. Once the swelling has lessened, apply a warm compress, which may help the bruise disappear faster. Bruises can be covered up with special makeup from your local pharmacy. That should look good on your a**.

And next time, padded shorts are not the worst idea. . . .

drdh

 
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