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How MISS Supports Optimal Patient Outcomes

Until recently, spine surgery was conducted in an “open” manner. Advances in surgical technique and instrumentation have enabled more surgeons to refine the performance of a myriad of procedures. Advances in imaging and other diagnostic tools have led to a greater understanding of anatomical structure, which is crucial to patient outcomes, particularly in the area of spinal surgery. In combination, these advances have culminated in the increased awareness, interest, and performance of minimally invasive spinal surgery procedures.

The value to patients is clear. A minimally invasive surgery, as opposed to open surgery, support a much faster and more comfortable recovery. There are less blood loss and a much lower risk of infection during a minimally invasive surgery due to the inconsequential nature of incisions. Spinal specialists want to be experts in the performance of minimally invasive techniques; and they want to confidently demonstrate this expertise to their patients, which is why bioskills training is so important.

Minimally invasive spine surgery has been in a constant state of development since the 1960s, though the last few decades have been a time of significant improvement. Starting with a small group of surgeons who developed microsurgical techniques, the use of minimally invasive procedures has continued to expand, with each surgeon at the forefront of new techniques thoroughly testing them and then passing them on to others.

Minimally invasive surgical techniques have resolved one of the major issues faced by spinal surgeons: how to minimize tissue and nerve damage to the greatest degree while obtaining access to a relatively small part of the spinal column. There is a significant amount of anatomy in the way, but to cut and open a wide area of tissue would be to create inherent risk. […]

Botox May Be Common, But That Doesn’t Mean It’s Easy

Millions of men and women get Botox treatment every year. Because the effects of this injectable last only 3 to 6 months, you could say that hundreds of thousands of treatments are conducted on a weekly basis. Botox Cosmetic has been around since 2002. That’s a long time for studies and clinical usage to point to the various finite details we need to know. It’s also ample time for practitioners to become complacent. Here, we want to point out some of the mistakes that are possible with Botox in hopes that we can help you avoid them through proper training.
Overtreatment

This may be one of the mistakes that are most feared – not only by patients but by practitioners. To use too much Botox means to transform the face into a blank canvas; one that cannot express. There are relatively few people for whom this is the true goal. Botox is not like hyaluronic acid dermal fillers; there is no reversing the effects if a patient is not completely satisfied with their results. To avoid overtreatment, it is vital to understand exactly what your patient seeks to achieve. It’s better to undertreat and repeat injections a week later if necessary.

Drooping

Drooping is a complaint expressed by many patients who are treated with Botox. To be clear, it is a complaint when this drug is used without proper consideration for facial anatomy and patients’ habits. Individuals with hooded eyelids may be more susceptible to drooping when the frontalis muscle is injected. Effects around the eyes may be more prominent if the patient is in the habit of raising his or her eyebrows, which many people are when they are dissatisfied with a heavy brow. Care must be […]

May 15th, 2017|Botox|0 Comments

The Value of Arthroscopic Training

The medical and surgical fields have been in such a state of innovation for so long that staying abreast of the latest and greatest trends may start to feel overwhelming. If you are in the orthopedic specialty, you want to procure the full extent of training necessary to improve patient outcomes. This may involve advanced education in the area of arthroscopic surgery.

Arthroscopy can be very useful for the surgeon who needs to observe the intricacies of any joint. Historically, physicians have relied on x-rays and other methods of imaging to extract meaningful data. Of course, there is nothing like an up-close-and-personal, real-time view, especially when this can be obtained in a minimally-invasive manner.

Arthroscopic procedures are commonly performed on joints including the:

Hips
Knees
Shoulders
Ankles
Wrists
Elbows

Each of these joints is complex and susceptible to a wide variety of injuries. Through arthroscopic surgery, an orthopedic physician can determine the source of pain and extent of an injury and, in many cases, make the necessary repairs through the same tiny incisions.

Surgery is a big decision for every patient. Knowing that a surgeon uses minimally-invasive arthroscopic technique may be the tipping point that allows a patient to feel more comfortable receiving care. Surgeons trained in arthroscopic technique can outline benefits to their patients. These may include:

High precision. Because observation of the joint takes place through a small camera at the end of a fiber-optic tube, a surgeon gains the most accurate view possible, without requiring a large, open surgery.
Lower risk. Surgery carries risk. This is precisely why it is a big decision for a patient to make. Because arthroscopy does not require large incisions, the surgical site remains localized and protected. Trauma to surrounding […]

What is on the Horizon for Skin Cancer Screenings?

Dermatologists understand the immense value of those routine skin cancer exams, even if patients are still catching on. The more consumers have learned that early detection is the X-Factor in the successful treatment of various health conditions, the more scientists have begun researching ways to help doctors and patients attain that goal.

Skin cancer is an interesting condition in that, although it is the most common form of cancer, and although awareness in prevention has increased, there is still a vast valley that needs to be bridged. Patients are not getting the screenings that could save them from unnecessary and extensive treatments. The fear of hearing that they have skin cancer is standing in the way of the early diagnosis and treatment that could save their life. The times, they are changing, though. Now, it seems there is new technology on the horizon that could be a real game-changer for skin cancer detection.

Recent research out of Stanford University is showing just how advanced science has become. Computer scientists, not health providers, have made significant steps forward in the development of a high-tech, albeit convenient, method of assessing suspicious growths. Ultimately, this new research in algorithms related to skin cancer could come down to a simple smartphone app.

The study, which can be read in a January 2017 issue of Nature, suggests that the artificial intelligence developed by Stanford scientists is as accurate as the current methodology of assessing abnormal cells using a dermatoscope. It is as if the visual processing of this artificial intelligence essentially puts another set of eyes onto the issue of skin cancer; a set of “eyes” that consumers may reach for before calling their dermatologist.

Stay in the Know

We cannot say that we aren’t […]

Carb-Specific Diet may Help Children with Irritable Bowel

Patient care involves a great deal of research in many cases. Just as every disease or condition has nuances, so does every patient and the way he or she responds to various therapies. When it comes to treating pediatric conditions, physicians show preferences for avoiding surgical intervention whenever possible. According to recent research conducted by physicians from Children’s Healthcare of Atlanta and Seattle Children’s, diet may be a vital element to putting conditions like ulcerative colitis and Crohn’s to bed.

The study involved the use of a carb-specific diet for a 12-week period. No other intervention was performed adjacent to this diet, which contained NO processed foods, dairy, grains, or sugars (honey was the only exception). Children participating in this study consumed a nutrient-dense diet of fruits and vegetables, nuts, and meats.

Of the 10 patients who participated in this study, 8 entered into a remission state using diet alone.

Prior to this formal study, only anecdotal evidence was available to suggest dietary modifications as an intervention therapy for children with inflammatory bowel disease. Now, it seems that we are gaining new data to support the use of food as medicine.

The Standard

For several years, the standard of care that has been placed on conditions such as irritable bowel and ulcerative colitis, among all age groups, has been based on the use of pharmacological agents. Steroids can diminish symptoms by reducing inflammation in the bowel, and other medications have been prescribed to manage symptoms such as bloating and diarrhea. The long-term use of such medications, though, are not without consequence. Plus, this approach does not resolve the underlying cause of these conditions, which some researchers believe ties to the microbiome in the digestive tract.

Whatever tool a physician can […]

Advances in Aesthetic Medicine mean there is Always Something to Learn

With every advancement in science, we gain better ways to accomplish goals. The field of aesthetic medicine has evolved at a rapid pace thanks to the development of numerous technologies and new techniques. As the new and improved elbows-out antiquated processes, we notice a shift in trends. Some of what has been sitting at the horizon throughout 2016 is expected to remain on trend for the coming year. These aspects of aesthetic care include . . .

Customized Programs for Rejuvenation

Each skin type is unique, and now every professional from the esthetician to the dermatologist has the right tools to address concerns ranging from chronic acne to the signs of aging for each individual patient. Skin care has come so far that some physicians have learned how to test the DNA for processes like the breakdown of collagen, or the type of antioxidants a person’s skin needs most.

Fat-Adding Procedures

Cosmetic surgeons are using fat for several face and body procedures today. An example of the value of autologous fat grafting is the results of the modern-day facelift. Rather than tightening skin and tissue over the skull, skilled practitioners are recreating youthful contouring by complementing the lift with volume restoration. Fat grafting restores plumpness to the cheeks and other areas that would otherwise look flat or hollow after facelift surgery.

Another example of fat grafting is the ever-popular Brazilian Butt Lift procedure. This surgery has all but replaced buttocks implants, appealing to patients who want an all-natural way to accentuate this part of the body. Like autologous fat transfer to the face, the Brazilian Butt Lift involves a liposuction procedure on a part of the body such as the abdomen, the processing of fat cells, and the subsequent […]

Patients Need to Know the Benefits of Low Impact Exercise

We talk a lot about health and wellness, but sometimes it is in vague terms. Eat less fat. Eat more fat. Exercise, but not too much or you’ll hurt yourself. What is right? In fact, it may all be right. Every patients is a unique individual, and that means that the savvy healthcare provider will develop an arsenal of information from which to draw when providing personal care. Here, we will discuss the value of low impact exercise for a large majority of people.

What is Low Impact Exercise?

To exercise with low impact technically means that one foot is always on the floor. We do this when we walk, when we hike, when we do yoga, and even when we dance. This way of exercising is often associated with older folks. However, studies show that low impact workouts offer significant benefits to adults of all ages. These include:

Healthier joints. We are learning more and more how crucial it is to take care of our joints earlier in life so they continue to function well later in life, when the aging process naturally affects their lubrication and mobility. Low impact exercise decreases the blunt force on joints in the knees and feet, and possibly even in the hips.
Healthier weight. Let’s face it, the person whose joints are chronically stiff and uncomfortable is the person who may not have a desire to exercise. This could lead them to decrease their caloric intake in order to lose or maintain a healthy weight. We know that 3500 calories need to be burned in order to lose a pound. Without exercise, that would equate to a 700 calorie deficit each day. Not very healthy. Add in an hour of […]

Pelvic Organ Prolapse: Looking Beyond Mesh

One of the biggest pieces of news in the field of urogynecology has been the persistence of lawsuits related to transvaginal mesh. This type of medical device was first developed in the 1950s. It resembles fishing net, and was originally intended to act as a barrier for surgical patients. Transvaginal mesh treatments did not begin until sometime in the 1970s, when the netting material was deemed appropriate to support pelvic organs to stop prolapse, as well as stress urinary incontinence. At the height of use, it is estimated that more than 100,000 implantations were performed in the U.S. And then the problems began . . .
Fast Forward

Gynecologists, family physicians, and urogynecology specialists should be well aware of the problems attributed to the unremovable transvaginal mesh. To that end, we will fast forward in our discussion of alternatives to the controversial surgery.

If the issues at hand is stress urinary incontinence, science now has new ways to improve on old techniques for resolution. For years, women have been encouraged to strengthen the muscles of the pelvic floor using Kegel exercises. The problem with this approach has been largely overlooked. If not performed correctly, Kegel exercises may not achieve the desired outcome. For that reason, more physicians are obtaining training for biofeedback. Stress urinary incontinence may also be improved with the support of an appropriate sling, or even with innovative radiofrequency treatments that reinstate the proper laxity and elasticity to the vagina.

Women affected by pelvic organ prolapse also need an alternative to transvaginal mesh, and they are finding it with sacrocolpopexy. Many surgeons are now performing this gold-standard treatment using the Da Vinci robotic platform. The procedure restores the correct anatomical position to the vagina using […]

November 15th, 2016|Medical Training|0 Comments

Why a Mental Health Day Matters, and How to Maximize it

We have all either been there or are fast approaching that moment when taking a break from the day to day hustle becomes an absolute must. Our need to get away from it all has actually been made formal. World Mental Health Day for 2016 is October 10th. In case you missed it, know that you don’t need an excuse to take care of your emotional needs. In fact, there are very good reasons to do so.

According to research, a large majority of the average person’s stress comes from work. This is true no matter how much you love what you do. Here’s a clue: if you feel anxiety tugging at your gut when you walk into your office, you need a day off. Research also shows that, when we do unplug as needed to lower our stress levels, we return to work more productive. One last bit of research . . . The American Psychological Association reports that nearly half of American adults (42%) are not taking steps to manage stress.

How to Tackle your Mental Health Day
We do a lot of talking about training and why it matters, but unwinding is equally as important, especially for those who consistently provide care for others. While it can be tempting to take a day off here and there to check off some items on your personal to-do list, that is somewhat counterproductive to the intent of this mode of self-care. Here are some ways that you can get the most from your mental health day.

Get a nature wash. If you haven’t heard of forest bathing, you’re missing out. The idea that nature is nourishing extends beyond the forest and all the way to the […]

October 15th, 2016|Mental Health|0 Comments

Ankle Replacement Surgery: How Modern Medicine is Making Strides

The arthritic condition, in any joint, results in uncomfortable swelling and stiffness. Because the ankle is such a small joint, and because it is also a weight-bearing joint, the symptoms of arthritis are often exaggerated compared to other areas of the body. When we walk, the ankle joint absorbs our entire body-weight. If arthritis is present, every step could be excruciatingly painful. Now, innovations in ankle replacement are giving new hope for pain free mobility in patients with arthritic ankles.

What Causes Arthritis in the Ankle
According to experts, the arthritic condition in the ankle joint often occurs as a consequence of an injury. Degenerative joint disease, mechanical instability, rheumatoid arthritis, and other conditions could also instigate this problem. Whatever causes the chronic degeneration and inflammation in joint cartilage, once this structure is lost, it cannot regenerate.

Treating Arthritic Ankles
Typically, the front-line treatment for ankle arthritis is some type of bracing. This often coincides with modifications to routine activities and treatments for pain and inflammation, such as cortisone injections. In the past, if more conservative care was unsuccessful, the surgical solution to arthritis in the ankle was to fuse the joint. Ankle fusion joins the bones in this structure to improve stability and put an end to pain. However, this surgery also affects the patient’s gate, or mechanical function of walking, due to the lack of movement in that joint. What physicians are now working on is a total ankle replacement.

If you’re in the field of orthopedics, you are probably saying “this is not new!.” Right. Ankle replacement surgery has been around for some time. The problem is that the standard procedure that has been taught has failed to provide acceptable results. The primary reason has been […]

September 15th, 2016|Medical Education|0 Comments