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Protecting Your Most Mobile Joint – Shoulders

shoulder pain

Whether shooting hoops, lifting boxes or pushing a lawn mower, we rely heavily on our shoulders to perform a number of activities. It’s also the most mobile joint in the body, which is why it’s the most vulnerable to injury.

To help prevent shoulder problems and injuries, it’s important to understand common conditions and when it’s best to see the doctor.

  • Shoulder Instability – Most common in young people and athletes, shoulder instability occurs when the muscles and ligaments holding it together are stretched beyond their normal limits.
  • Shoulder Dislocation – Often caused by a significant force, the shoulder joint is the most frequently dislocated major joint of the body — separating the joint’s ball (the humerus) from its socket (glenoid).
  • Rotator Cuff Tear – A group of four muscles of the upper arm, the rotator cuff allows you to raise and rotate the arm. When these tendons tear, it makes it hard for the ball to move in the socket.
  • Frozen Shoulder – Extreme stiffness, or Frozen Shoulder, can happen at any age when a minor shoulder injury heals with scar tissue that affects how the joint moves.
  • Overuse or Strains – Most common in middle age adults, overuse or strained shoulders occurs with a sudden increase in activity—placing great stress on the joints and leading to a loss of flexibility.
  • Arthritis – Starting as early as age 50, osteoarthritis or painful movement in the shoulder may cause problems for some people.

Shoulder Arthritis

Shoulder arthritis can be terribly disabling to those who have this condition. The pain, stiffness and loss of function make day-to-day activities very stressful.

Function Follows Form

The shoulder is a “ball and socket joint.” The surface of the ball (humeral head) and the cup (glenoid) are both covered with a shiny, smooth surface called cartilage. These surfaces enable the healthy shoulder to move smoothly through a pain-free range of motion.

The healthy shoulder has a much larger range of motion than most joints in the body, allowing people to perform activities in front of them, above their heads, and behind their backs in a pain-free manner.

When the shoulder surface cartilage has worn away, patients experience a loss of motion, pain and sometimes crunching, catching and locking when the shoulder is moved. This loss of motion makes it very difficult to do movements away from one’s body or above one’s head. Reaching behind one’s back is significantly affected, and the pain often causes other problems including difficulty sleeping.

Getting You Back in Form

Nonsurgical approaches are recommended as first steps. These include anti-inflammatory medications, cortisone shots and physical therapy designed to optimize shoulder motion and strength. When these treatments no longer work, surgical approaches can help reach the goals of eliminating pain and restoring motion as quickly as possible. Every patient is different, and surgical approaches are tailored to each patient’s specific needs.

If you’re experiencing shoulder instability, immobility or pain, attend our Nov. 9th talk: Shoulder Pain – Causes, Treatment and You. Click here to register.


Dog and Pet Therapy Volunteer Receive Award

Jim Papenfuss and Prince

For the first time ever, a four-legged volunteer and his owner received Ascension’s quarterly High Five award.

Jim Papenfuss and his loyal Golden Doodle, Prince, also received accolades from State Senator Ron Johnson’s office and the Oshkosh City Mayor.  In addition, this dynamic duo was featured on a local TV news station (watch the video).

Jim and Prince provide pet therapy at Mercy Medical Center, Affinity Home Health, and Bethel home among many other Oshkosh area agencies.  At Mercy alone the pair has given over 400 hours of service to our patients, visitors and staff.

“Big ball of cotton candy”

Jim has been involved with pet therapy for the past 18 years. He and Prince enjoy interacting with others and cheering up those in need. Prince, also known as “Jim’s big ball of cotton candy,” loves working with everyone at the hospital, exhibiting kindness and love.

Mercy Medical Center is fortunate enough to have this dynamic duo that are always bringing smiles and joy to everyone around them.

Volunteer Spotlight Jim+ prince 6-9-15

Looking for ways to get involved in your community?

Mercy Medical Center has volunteer openings! Volunteers enjoy directing visitors, transporting patients, running errands, and many other tasks including providing patients’ socialization rehab through animal therapy.

If you are interested in joining the volunteer team at Mercy, please visit our website http://www.affinityhealth.org/volunteer to apply online or contact Mercy Medical Center Volunteer Services at (920) 223-0225.

Interested in pet therapy?

For those specifically interested in pet therapy, after applying online your dog must meet the standards set by Therapy Dog Inc., which includes being a friendly, well-behaved dog of at least one year of age. For more information on testing and qualifications, please contact therapydogsinc@qwestoffice.net.

Flu Season Health, Vaccinations and Prevention

flu season vaccine

Flu season is here. To protect yourself and others, it’s important to schedule a flu shot with your Primary Care Provider.

2016 Flu Vaccine Update

If you have kids, the American Academy of Pediatrics no longer recommends the nasal spray vaccine after studies showed poor effectiveness. Therefore, our clinicians only offer the shot vaccine.

For this year, there are still several good flu shots options available:

  • For children age six months to three years, we have the injectable quadrivalent flu vaccine. This contains four strains of influenza.
  • For children age three years and older and all adults, we also have the injectable quadrivalent flu vaccine with the same four strains.
  • While most people with egg allergies can still get a flu shot, there is a completely egg-free injectable option that is approved for people age 18 years and older.
  • For adults age 65 years and older, we can provide the injectable high-dose flu vaccine that provides extra protection against three of the flu strains expected to circulate in our community.

Common questions about flu vaccinations

How well does the flu vaccine project someone from the flu?
There are many different strains of influenza, so the vaccine—and its effectiveness—can vary from year to year. Each year a vaccine is developed to match the strains expected to be prevalent in the coming flu season. While it is impossible to predict the prevalent strains exactly, the vaccine is the best defense against the flu. Its effectiveness also depends on your typical health; the vaccine is effective, but it won’t make you invincible.

Is there a vaccination for children and a different vaccination for adults?
There are two different types of flu vaccines: trivalent, which protects against three strains of the flu, and quadrivalent, which protects against four. Ask your provider which vaccine is best for you.

Which is better, the shot vaccine or the spray vaccine?
The shot vaccine is more effective. As of 2016, the American Academy of Pediatrics no longer recommends the nasal spray vaccine after studies showed poor effectiveness.

Can you get the flu shot if you are pregnant?
Yes! The elderly, those in poor general health and pregnant patients are at particular risk of influenza, making it an even higher priority to get vaccinated.

Where/when can I get a flu shot?
You can set up an appointment to receive a flu shot by calling your provider.

To learn more about influenza, vaccines and risk factors, visit www.cdc.gov/flu/protect/keyfacts.htm or contact your provider.

Staying healthy during flu season

While the best way to stay healthy this flu season is to get vaccinated, here are some other things you can do to protect yourself:

1.  Practice good hand hygiene. Encourage everyone in your family to practice regular hand-washing, especially after using the bathroom, before and after handling or eating food and after coming in from the outdoors. Hand-washing is one of the best ways to remove germs, avoid getting sick and prevent the spread of germs to others.

When soap and water aren’t available, gel sanitizers or wipes containing 60-90 percent ethyl alcohol or isopropanol are the next best thing. Keep these in your car, purse or desk. Using a dime-size amount of gel, rub your hands together, covering all surfaces of the skin and nails, until the gel is dry.

2.  Take cover. Get into the habit of sneezing into your inner elbow. If you have a tissue, cover your nose and mouth with it when you sneeze or cough.

3.  Don’t touch. Avoid touching your face, eyes, nose or mouth with your hands.

4.  Replace and wash items. Buy a new toothbrush after a cold or other illness. Wash your bedding at least once a week, especially pillow covers. Wash gloves, scarves and any other attire that covers your face or mouth. This is helpful in keeping germs away.

5.  Stay hydrated. Dry nasal passages make it easier for the flu virus to breed, so its important to drink plenty of fluids. Water is a natural moisturizer for the inside of your body. Aim for eight cups of water a day. Swap out fizzy carbonated drinks for herbal tea. Increase your fluid intake if you are on a high-fiber or high-protein diet.

6.  Keep it colorful. Eating lots of junk food, skipping meals and consuming lots of caffeine can increase your chances of becoming ill. Eating a well-balanced meal comprised of fruits, vegetables, whole grains and lean proteins can help keep you healthy. Need some food inspiration? Check out some of these healthy recipes: http://blog.affinityhealth.org/?s=recipes

7.  Take time to relax. Managing stress and making time for relaxing activities is very important in maintaining good health. Meditation, exercise, napping, getting a massage or reading is a good way to reduce stress. Carving out “white space” in your calendar so you can fit these things into your life is the first step in claiming some “me” time.

8.  Get some ZZZZs.  According to the National Sleep Foundation adults need between seven to nine hours of sleep a night. A lot of Americans do not get enough sleep. Lack of sleep wreaks havoc on your health and can make you more susceptible to illnesses. It can contribute to work errors, car crashes and industrial disasters. Sleep deprived individuals are also more likely to suffer from chronic conditions such as diabetes, depression, obesity, etc.

Hopefully, following these tips will help you stay healthy! If you do get sick, treat yourself kindly. It takes energy for your body to fight the organisms making you sick. Stay home to avoid spreading germs. Rest, proper nutrition and hydration will help. Stay well!

Are You at Risk for Breast Cancer?

breast cancer group of women

Any woman may develop breast cancer; however, the following risk factors may increase the likelihood of developing the disease.

Risk Factors that Can’t Be Changed

  • Gender. Breast cancer occurs nearly 100 times more often in women than in men.
  • Race or ethnicity. It has been noted that white women develop breast cancer slightly more often than African-American women. However, African-American women tend to die of breast cancer more often. This may be partly due to the fact that African-American women often develop a more aggressive type of tumor, although why this happens is not known. The risk for developing breast cancer and dying from it is lower in Hispanic, Native American, and Asian women.
  • Aging. Two out of 3 women with invasive cancer are diagnosed after age 55.
  • Personal history of breast cancer.
  • Previous breast irradiation.
  • Family history and genetic factors. Having a close relative, such as a mother or sister, with breast cancer increases the risk. This includes changes in certain genes, such as BRCA1, BRCA2, and others.
  • Benign breast disease. Women with certain benign breast conditions (such as hyperplasia or atypical hyperplasia) have an increased risk of breast cancer.
  • Dense breast tissue. Breast tissue may look dense or fatty on a mammogram. Older women with high dense breast tissue are at increased risk.
  • Diethylstilbestrol (DES) exposure. Women who took this drug while pregnant (to lower the chance of miscarriage) are at higher risk. The possible effect on their daughters is under study.
  • Early menstrual periods. Women whose periods began early in life (before age 12) have a slightly higher risk of breast cancer.
  • Late menopause. Women are at a slightly higher risk if they began menopause later in life (after age 55).

Lifestyle-Related Risk Factors

  • Not having children, or having your first child after age 30
  • Recent use (within 10 years) of oral contraceptives
  • Physical inactivity
  • Alcohol use (more than 1 drink per day)
  • Weight gain and obesity, especially after menopause

Your Next Steps

It’s important to talk with your doctor about your risk developing breast cancer and to develop a screening plan that’s right for you.

Don’t have a primary care doctor? Call Nurse at 800-362-9900 to find one today.

Pedal to the Metal

pedal to the metal - orthopaedics

An Orthopaedic Success Story

Leon Luker lives with four artificial joints and severe arthritis, but he survives on faith in orthopaedic medicine and the fact that he can still feel his ATV accelerate beneath his feet.

Leon Luker finds pleasure in simple joys, like picking wild asparagus, tending the garden and taking long rides on his Honda ATV through and over 400-some acres of land that his family owns. He’ll be the first to tell you it isn’t always easy, the last to say “I can’t” and slowing down is something that he generally detests.

This is because Luker, who lives in Black Wolf with his wife, Jane, has had nine orthopaedic operations and is living with four artificial joints. Most days are accomplished with the help of a catnap, the support of his family and optimism like none other.

The 65-year-old has lived a labored life. His first taste of contact sports was as a 10-year-old and his active lifestyle carried on through high school where he was considered one of Oshkosh’s top athletes.

“As a young man, I knew I was putting myself through a lot,” Luker says. “But I pushed myself. That’s just who I am.”

He bounced between football, basketball and track and field in high school before joining the men’s basketball team at the University of Wisconsin Oshkosh.

Not long after starting college, he dropped out to work for his father, Leon Luker, Sr., in construction. Labeled as the “big guy,” coworkers would request Luker to help with heavy lifting. From strains and dislocations to bumps and falls, Luker’s body took a beating.

A couple of short decades later, the damage control would begin.

bionic man

Disjointed: Operations and replacements

Luker had his first reconstructive surgery performed by Dr. Roy Buck at Mercy Medical Center in 1983 to repair the ligament and cartilage in his right knee. A doctor at a different hospital performed an arthroscopy on his right knee in 1995, and that same doctor operated on Luker when he was in a serious accident at work involving a forklift in 1999. He suffered a right leg fracture, right ankle injury and left leg injury.

Severe arthritis was the reason Luker had surgery twice in 2007 – his right rotator cuff in January and a right knee replacement in November.

But three years later, Luker experienced a rare orthopaedics emergency.

Half way through the day on February 14, 2010, Luker noticed his right knee was stiff and he started to feel ill. Forced to cancel Valentine’s Day plans with Jane, he went to bed. The next day he was running a fever and experienced tremendous swelling in his knee. Trying to bend it was no easy task. He decided to go to the hospital, but even that proved difficult.

The only way Luker could get to Mercy Medical Center was by laying down in the back of his suburban.

After a short visit in the emergency department, Luker was admitted to the hospital’s second floor – orthopaedics. Dr. Davis Tsai, orthopaedic surgeon for the Kennedy Center at Mercy Medical Center, arrived to assess Luker’s knee.

The unusual illness and stiffness Luker experienced was caused by septic arthropathy (disease of the joints) with sepsis (an infection in the bloodstream).

According to Dr. Tsai, the professional rule of thumb is the surgeon who did the surgery should take care of the joint. But a doctor in Green Bay had performed Luker’s right knee replacement and since he had been admitted to Mercy Medical Center, Dr. Tsai had to step in.

“At that point in time he was fairly ill,” explains Dr. Tsai. “The leg looked horrible with ankle ulcers, but his organs were threatened and had not begun to fail.”

Dr. Tsai removed the hardware of the implant and positioned a cement block with a high concentration of antibiotics in his knee.

After the surgery, Luker was restricted to a hospital bed without a right knee. He was now considered an “explant” patient (when a joint is “explanted” from the body) and the long journey to recovery began with basic rehabilitation. Dr. Tsai couldn’t replace the knee until the infection healed.

“My leg moved like a snake,” Luker says. “It would go in every direction. The nurses knew just how to position and move my leg to relieve my pain.”

Luker was moved up to the subacute unit on the fifth floor in Mercy Medical Center, which is an in-hospital based nursing home. It was there that he met two individuals, Chris Barczak and Tami Morrow, who worked in two different departments. Both Barczak and Morrow would be crucial to his recovery.

On the mend

Barczak is a physical therapist and the clinical coordinator of inpatient rehabilitation services at Mercy Medical Center. He has seen cases like this before, sometimes even a couple of times a year, but he had never met anyone like Luker before.

“He’s a big and tall guy, and I’m 5’4” and 140 pounds,” Barczak says. “We’re a mix-matched duo that way.”

Luker’s size made rehab a little difficult. Therapy started with the basics: rolling side-toside, sitting up and lying down. It took Barczak and the assistance of a student therapist just to help Luker stand.

“The problem was the pain he was in because of the whole body infection,” Barczak explains. “The infection attacked both shoulders, both hips and his good knee, which also needed to be replaced. He basically didn’t have a ‘good leg’ to stand on.”

“Chris would get me up without a knee,” Luker says, his voice giving way to a great sense of pride in his therapist. “He said I had to stand and I would.”

Having only been a registered nurse for about a year, Morrow had never cared for an explant patient before Luker. From the very first time they met, the two were like old friends.

“When patients tell you what their goals are, it makes you feel really connected,” she says. “He called himself a bionic man. I remember him saying he wanted to get back on that four-wheeler.”

Changing his dressings caused Luker a great deal of pain. The two developed a system where they would lift up his jointless leg together at the same time. There was a great deal of swelling in the lower part of his legs because of his venous stastis, a condition where blood flow is slow in the veins. Morrow, along with other staff, would assist in putting on “special” tube socks each day, sometimes twice a day.

“The tugging and pushing that was required to get the socks on was excruciating for him, but he’d describe what I had to do,” she says.

When he wasn’t doing rehab, Luker was in the company of his family and also received regular visits from the spiritual services team at Mercy Medical Center.

Six weeks later, Luker returned to orthopaedics to have Dr. Tsai replace his right knee again.

After Dr. Tsai completed the replacement surgery, Luker returned to the fifth floor where the plan was for him to finish about one more week of rehabilitation. After many long weeks in the hospital already, Luker asked Barczak point blank what he had to do to go home sooner.

Luker had to walk to the end of the hall and back. So he did that. Then, he had to go up and down a series of steps. He did that, too; not without pain, but he did it. His nearly 12-week hospital stay had finally come to an end.

Luker and physical therapist

Luker with physical therapist, Chris Barczak, at Mercy Medical Center, Oshkosh

“It was Leon’s hard work that got him through it – gritting his teeth, pushing through the pain, actively working on getting better and moving better,” Barczak says. “It was meaningful for me to be a part of that and see him through.”

Today, Luker walks with the help of a cane but enjoys it most when it’s strapped to the front of his ATV.

Luker’s most recent surgery was in February 2011. Dr. Jeffrey McLaughlin orthopaedic surgeon with the Kennedy Center, replaced his left hip.

“The cartilage around his hip bones had worn away and was like sandpaper rubbing together,” Dr. McLaughlin explains. “I don’t know how he walked on it as long as he did.”

According to Dr. McLaughlin, the techniques of orthopaedic surgery have modernized. Today, he can accomplish a hip replacement surgery in about 40 minutes. “It’s not a small operation, but it used to be a very big operation,” Dr. McLaughlin adds. “You used to be in the hospital for 10 days and recovery took about four months. Now, a patient spends only three days in the hospital and six weeks to recover.”

Strength of steel

Dr. McLaughlin predicts that Luker’s right hip will have to be replaced sometime down the road, but until then, Luker pushes on putting his pedal to the metal.

If you ask him about the support system he has in his parents and Jane, he gets choked up.

Leon Luker and wife

“Jane never missed a day,” he says. “She was my rock. She’d watch the nurses and catch on after seeing it once.”

Morrow fondly remembers Luker’s mother, Ann Marie, and father, Leon Sr., and the amount of devotion they had for Luker while he was in the hospital.

“His family was there to bathe him so the nurses never had to,” Morrow shares. “They wanted to be involved and they’d do anything for him as far as his personal needs went. They were remarkable.”

Ann Marie, who fits snuggly in the underarm of Luker as he pushes up against her for a hug, says simply, “We made it.”

But not without the help and dedication of the hospital team at Mercy Medical Center.

Luker contributes his recuperation to the surgeons, nurses, therapists, pastoral staff, administrators and Network Health Plan representatives.

“The only time I don’t feel handicapped is when I’m on my ATV,” he says. “But who knows if I’d even be able to ride that thing if it weren’t for Dr. Tsai and Dr. McLaughlin. They have given me the opportunity to have my life back again.”

If you’re experiencing shoulder instability, immobility or pain, attend our Nov. 9th talk: Shoulder Pain – Causes, Treatment and You. Click here to register.

Disclaimer: The information found on Affinity's blog is a general educational aid. Do not rely on this information or treat it as a substitute for personal medical or health care advice, or for diagnosis or treatment. Always consult your physician or other qualified health care provider as soon as possible about any medical or health-related question and do not wait for a response from our experts before such consultation. If you have a medical emergency, seek medical attention immediately.

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