Health Information
LAMC Orthopaedic Surgeon introduces Direct Anterior Hip Replacement
Click here to read about the new technique and the new technology that have produced some amazing results for Dr. John Garcia.
LAMC General Surgeon offers new technique for GERD
Click here to read the details of this new procedure. Dr. Rodney Barker is among the first surgeons in the state of offer this technique. Click here for Frequently Asked Questions regarding GERD.
"Swine" flu
Click here to read about "Swine Flu", more correctly known as H1N1. En Espanol.
Dr. Miles Nelson, an emergency physician in Northern New Mexico, presents his perspective on the current healthcare concerns. Click here.
Click here for the most recent recommendations from the New Mexico Department of Health.
HealthPoint
HealthPoint is Los Alamos Medical Center's community newsletter. Click here to read the most recent edition.
Click here for past editions:
To Your Health
You can hear "To Your Health" with Lyle Dean on KZRM Radio96.1FM, kzrmradio.com/96.1/ sponsored by LAMC. Read these informative tidbits at http://tyh.lyledean.com/client/Default.aspx?id=19 .
Healthy Man
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Self-assessment tools
Click here for a variety of self-assessment calculators.
Medical Minute Archives
"Medical Minute" is a monthly column written by LAMC physicians, directors, and leaders. It appears monthly in the Los Alamos Monitor, www.lamonitor.com . Click here for the current month's column. Below are selected column archives.
Colorectal Cancer Awareness Month
By MARK KARAFFA
Colorectal cancer continues to be the second leading cancer killer for both men and women combined in the United States, even though it is 90 percent preventable and 90 percent treatable when detected early.
These figures are of great concern to care providers and staff at Los Alamos Medical Center, because we know that fewer than 50 percent of adults age 50 or older have had one of the readily available colorectal cancer screening tests within the recommended time periods. That is truly unfortunate because when detected at an early, localized stage, colorectal cancers are nearly 100% curable; however, only 39% of these cancers are diagnosed at this stage, mostly because of low rates of screening.
Enter the month of March, also known as ‘Colorectal Cancer Awareness Month’, and LAMC’s ColoCARE awareness campaign. Our physicians are telling us that we can save more lives, and we’re going to focus on doing just that – by educating the public about colorectal cancer and the screening tests that are available. We’re taking advantage of this special month to make sure everyone in the communities we serve knows when they should be screened. Most people do not realize that you can actually prevent colon cancer, in many cases, by simply having a colonoscopy.
Colorectal cancer, which includes cancers of the colon and/or rectum, is equally common in both men and women. The American Cancer Society estimated that last year (2008) 148,810 new cases of colorectal cancer were diagnosed and that 49,960 people died from the disease. It is also one of the most easily prevented cancers because it can develop from polyps that can be removed before they become cancerous.
More than 90 percent of people who are diagnosed with colorectal cancer are over the age of 50. Many insurance plans, including Medicare, help pay for colorectal cancer screening.
Polyps and colorectal cancer may not cause symptoms, especially at first. And, like many cancers, the development of colorectal cancer can take many years, which is why screening is such an important tool. Regular screening tests can find precancerous polyps so they can be removed before they turn into cancer, and screening tests can help discover cancer in its earliest, most curable stages.
Experts are not in total agreement on which screening tests should be used or how often adults without known risk factors should be tested, but there is agreement on one test. Considering all of the available literature and research, conventional colonoscopy remains the clear gold standard for the diagnosis of colorectal cancer. It allows the physician to examine the entire length of the colon and to remove pre-cancerous polyps during the same procedure. Anyone who is 50 years of age should have a colonoscopy. During this procedure, a physician uses a slender, flexible, lighted instrument called a colonoscope to look at the inside walls of the full length of the colon. If abnormalities are found, they can be removed or biopsied during the same procedure.
Colon cancer is responsible for 10-11% of all cancer deaths. One out of every three people who develop colon cancer will die from it, most commonly because it is diagnosed at a late stage. Colonoscopies help to prevent these deaths.
During the month of March, you can take the first step toward prevention of colon cancer in your life and that of your loved ones. Through our ColoCARE campaign, you can receive a FREE ColoCARE Home Screening Kit with an easy-to-use test and information about the risks, treatment, and most importantly the prevention of colorectal cancer. All of the instructions are included; you just have to follow directions. Call 1-866-512-2380 to request a kit, and our staff will assist you in joining this important effort.
Remember that in spite of all the screening tests that are available, unfortunately, overall screening rates remain low. Colonoscopy is at least as important as mammography, a test sought much more routinely. Since colorectal cancer is the second leading cause of cancer death in both men and women, we could prevent great suffering if more people would take advantage of screenings that are available. Watch for your ColoCARE mailer coming soon, or call 1-866-512-2380 to get your kit. It may be one of the most important decisions of, and for, your life.
Mark Karaffa is the Director of Business Development at Los Alamos Medical Center.
What is a hospitalist?
By SARA PASQUALONI, MD
Since the initiation of the hospitalist program at
What is a hospitalist? A hospitalist is a well trained specialist who deals specifically with inpatient hospital care. We make daily rounds, and most importantly are available on an urgent basis should you have an emergency or a significant change in your condition. While you are under our care, we will be responsible for performing exams and ordering diagnostic tests and other treatments which are appropriate for your acute condition.
Why isn’t my regular doctor seeing me in the hospital? Your primary care provider has given the hospitalist program permission to care for your medical needs while you are in the hospital. During your hospital stay your primary care provider will be informed of your admission, condition, and discharge and will be able to monitor your course of care. Once you leave the hospital, your primary care provider will resume your outpatient care.
How can my family and I communicate with the hospitalist? We will meet with you at least once a day to discuss your condition, test results, and course of treatment. This is the best time to ask any questions regarding your medical care. If you or your family members have questions after daily rounds have occurred, please inform your nurse, who can then contact us. Due to governmental regulations which protect your privacy, we must be very careful regarding telephone conversations with family members without explicit permission from you. We will, however, do our very best to address your questions as quickly as possible.
What happens when I am discharged? Your care after discharge from the hospital is just as important to us as the quality of care you receive while in the hospital. When you leave the hospital your primary care provider will receive both a written and verbal summary of your hospital course, including test results and any prescribed changes in medical therapy. After your discharge you will follow up with your primary care provider, and if you do not have a regular doctor we can arrange for a visit with an LAMC medical staff member as deemed to be appropriate.
This week the hospitalist program, including myself, Dr. Lenny Noronha, and Dr. Tatiana Canning, celebrates its first annual anniversary at LAMC. What this means to you as our patient is a service that provides a new level of coordinated, seamless inpatient care as well as increased outpatient availability to your primary care provider on a day to day basis. We want to provide you with the best care possible, and are very pleased to have the opportunity to care for you at our great hospital.
Sara Pasqualoni, MD, is the lead hospitalist at Los Alamos Medical Center.
The ABCs of Knee Pain
By JOHN A. GARCIA, MD
As an orthopaedic surgeon and the newest member of
Today’s increasingly active society is experiencing more injuries related to the knee. Whether you are a weekend warrior pushing your body to the limits only when time allows, or a triathlete trying to get in as many miles as possible in a week running or cycling, most of you who are active have experienced some form of knee pain.
The knee is a complex joint composed of bones, muscles, tendons, ligaments, cartilage and a fluid network working simultaneously to allow propagation of the body. All are susceptible to injury depending on the particular activity, while treatment is dependent on the location and type of injury.
Overuse Injuries are common in endurance athletes and include the following:
Stress fracture - A mechanical failure of the bone secondary to repetitive loads transmitted to the bone from running or jumping. Recommended treatment is rest from the offending activity. A period of non-weight bearing on the extremity with crutches is sometimes prescribed.
Tendonitis - Inflammation of the terminal tissue connecting muscle to bone, i.e. quadriceps tendon (thigh muscle tendon) or patellar tendon (knee tendon). In general, tendonitis responds to a period of rest, stretching, ice treatment and anti-inflammatories such as ibuprofen.
Synovitis - An inflammation of the lining of the joint called the synovium. The synovium produces the lubricating fluid of all joints. Repetition of knee bending can cause this lining to become inflamed, swollen and thickened, often manifesting as increased fluid within the knee joint. Treatment includes rest, ice, anti-inflammatories, and, on occasion, aspiration of the synovial fluid and injection of the joint with corticosteroids. Rarely, if these methods fail to provide relief, arthroscopic surgery to shave away a portion of the inflamed synovium may be considered.
Chondromalacia - The gradual deterioration of articular cartilage, a protective cushion around the end of the bone within the joint. This results in pain with activities and at times can result in chronic pain. Treatment recommendations are geared towards activity modifications; if running aggravates the condition, try alternative activities such as swimming or cycling. Once the cartilage deteriorates, it does not rejuvenate as one might expect. Chondromalacia is often the early stage of a future arthritic knee.
Acute Mechanical Injuries to the knee are common in sports and activities which require quick acceleration, deceleration and pivoting, i.e. skiing, soccer, and football. Common injuries include:
Torn cartilage - A quick twist of the knee joint can injure the cushions within the knee. This can manifest as tear of articular cartilage or a torn meniscus (a shock absorber between the bones of the knee). Treatment depends on the location and severity of the tear. In general these injuries require further evaluation with imaging of the knee utilizing an MRI. Arthroscopic surgery may be indicated again, depending on the location and severity of the injury.
Torn ligaments - Ligaments are sturdy tissues that provide connections between bones at joints. They allow motion about the joint while providing stability. Depending on which ligament and the severity of the tear, treatment can range from rest and therapy to surgical reconstruction of the knee ligament.
Ruptured tendons - as previously noted, tendons are the connections between bones and muscle; they allow muscles to move the joint, i.e. jumping and running. Partial tears of tendons can sometimes be treated with rest and therapy; however, complete ruptures generally require surgical repair.
In my experience, the most common ailments to the knee are those described in the overuse category. In general they can be kept to a minimum with a well- rounded program incorporating different activities such as hiking, biking, swimming, walking and cycling. Variety is the spice of life, and when it comes to exercise, it is also the mantra to giving your knees a lifetime of longevity.
John A. Garcia, MD, is the new orthopaedic surgeon at
Urology for the 21st Century
By PAVEL MOURACHOV, MD
I am very excited about joining the medical center and the wonderful community of
Urology goes a long way back in time. Descriptions of operations for bladder stones were found in ancient Egyptian, Greek and Hindu writings. Our specialty has always been on the forefront of medical art as it evolved, frequently being the first field to introduce an entirely new way of treating a disease. For instance, the first medical endoscope – an instrument designed to look inside the body through a natural passage of a human body – was designed and used by a German urologist in 1878. Urologists strive to adhere to the tradition of embracing innovation today as they have in the past. Common urologic technologies include:
Laparoscopy: This method of performing complex surgery inside the abdominal cavity, with a camera and special instruments inserted through small incisions, has been gaining increased use in urology. Many operations for benign and malignant diseases of the kidney and prostate are now performed in this fashion, reducing the time needed for recovery and greatly diminishing patients’ pain.
Lasers: Urologists use a variety of lasers that allow precise delivery of very high energy through sophisticated endoscopes to treat kidney stones, enlarged prostate or small bladder tumors. The wavelength of the laser used is chosen to produce the best results for the type of structure being treated. Patients have minimal or no discomfort and usually go home the day of the procedure.
Microwaves and radio frequency: Devices that use this type of energy rely on the effect of heating produced when an antenna is placed inside or near the treated organ. Today, we use these methods for minimally invasive procedures to treat benign prostatic hypertrophy (BPH), a very common condition affecting men over the age of 50, in a safe, comfortable office setting. Transurethral Needle Ablation (TUNA) and Transurethral Microwave Therapy have become very popular alternatives to daily medication for men with BPH and for those whose medications no longer work. Radio frequency devices can also be used to treat kidney cancer.
Cryotherapy: This treatment is used to destroy malignant tumors of the prostate and kidney by freezing them to a very low temperature, eliminating the need for a major surgical operation. The current generation of cryosurgical probes, based on technology initially used to increase accuracy of heat-seeking missiles, utilizes the principle that a gas cools down as it expands inside a thin needle. The urologist places one or several of these needles into a tumor and then observes the borders of a growing ice ball with live ultrasonic imaging. This allows for very precise destruction of cancer while preserving surrounding tissues. Patients report little pain after the procedure, and the hospital stay is short.
Thank you for welcoming me to
Dr. Pavel Mourachov is the new urologist at