Pelvic Rehabilitation Medicine’s Post

Did you know that endometriosis falls into the category of an inflammatory disease process? Endometrial plaques release a form of “inflammatory soup” into the pelvis which contributes to inflammation around the pelvic nerves. For so many patients, they are left wondering why even after expert excision they remain in pain months (and years) after surgery. We asked Dr. Ally to weigh in. She said: with Endometriosis, surgery alone is NOT the answer - and it certainly is not the only treatment available for patients! WHY? Because endometriosis is a systemic, inflammatory disease process. This means the nerves and muscles in the pelvis must also be addressed in treatment, which is what the PRM Protocol™ was designed to do🎗 We know that excision surgery is the only way to REMOVE Endometriosis lesions and an important step to healing. However, overall at PRM our mission is to try and decrease the total number of surgeries our poor patients have to undergo in a lifetime as we often see patients who have repeat surgery after repeat surgery. Addressing comorbidities such as the pelvic floor and bladder before or after surgery can help optimize the surgical results and hopefully increase time before further surgery may be needed. In case you missed it on her IG @doctor.allyson we're reposting here. 💜

The modified frailty index (mFI-5) is an interesting, no time consuming tool to assess frailty status in preoperative cases, by doing this score we can have an idea of the risk of complications after surgery. This score has been shown to be reliable in different orthopaedic and spinal procedures, however, in surgeries with a low complication rate, this score might not be useful in assessing the preoperative risk, as we found in this study, check out our recent publication on the topic. #frailty #spinesurgery

Tune into Episode 10 of @behind_sports_med_podcast with Vascular Surgeon from the @vascularcaregroup Dr Zachary Fang. Dr. Zachary Fang from the Vascular Care Group discusses the procedure called GAE (Genicular Artery Embolization) for knee osteoarthritis. GAE is a minimally invasive procedure that targets the small blood vessels in the knee joint to block inflammation and reduce pain. It is an alternative for patients who want to delay or avoid knee replacement surgery. The procedure can also be done for patients who have already had a knee replacement but still experience pain. GAE is suitable for patients with comorbidities who are not candidates for knee replacement. The procedure has low risks and can provide long-lasting pain relief. Dr. Zachary Fang discusses the recovery process after geniculate artery embolization (GAE) for knee osteoarthritis. He advises patients to take it easy for the first 48 hours after the procedure and gradually resume normal activities over the course of a week. Pain relief post-surgery is not immediate, but patients typically experience a 25% decrease in pain in the first week, followed by a 10% reduction each week for six weeks. The majority of improvement is seen by three months, and long-term data from Japan shows continued pain reduction even after two years. GAE is a potential alternative for patients who want to avoid knee replacement surgery. If patients experience discomfort again several months after the procedure, a repeat GAE can be considered after at least three months. Dr. Fang also mentions the possibility of using GAE for other weight-bearing joints like hips and shoulders in the future. @atipt @nata1950 @apta_orthopaedic @societyforvascularsurgery #vascularsurgeries #physicaltherapy #athletictraining

91 (!) year old with past medical history of including coronary artery disease (CAD), hypertension (HTN), congestive heart failure (CHF) and pulmonary hypertension who underwent an L5 kyphoplasty at an outside institution for an L5 compression fracture. Of note, when she had the kyphoplasty, it was done under general anesthesia and it took 5 days to extubate her due to her comorbidities. After this kyphoplasty, she developed bilateral leg pain.  Her back pain, however, was improved with this procedure.  This leg pain was unable to be treated with pain medications.  On CT imaging, it is clear, that the cement that was used for the kyphoplasty had now moved into the spinal canal, compressing the nerve roots. How can we treat this patient in a manner to minimize risks? To see how we can combine the use of awake spine surgery, minimally invasive spine surgery and regional anesthesia to give this patient a great outcome, please see the following CME link. https://lnkd.in/eUeyQz4g  

What are the limitations of intravenous tissue plasminogen activator IV (tPA) for stroke? There are a number of limitations to the use of IV tPA for stroke, including: Prior stroke A history of an ischemic stroke within the last 3 months is associated with an increased risk of adverse outcomes when treated with IV tPA. Minor symptoms IV tPA is not recommended for patients with minor or rapidly improving stroke symptoms. Recent surgery Major surgery or serious trauma within the last 14 days is a contraindication for IV tPA. Recent bleeding Recent gastrointestinal or urinary tract hemorrhage within the last 21 days is a contraindication for IV tPA. Recent myocardial infarction A recent acute myocardial infarction within the last 3 months is a contraindication for IV tPA. Advanced age The risk of IV tPA may be increased for patients who are older than 75 years. Hospital characteristics location, volume of stroke patients, and whether it is a teaching hospital Method and timing of hospital arrival. #HealthCare #Pharmacy #Stroke #MI #tPA #PlasminogenActivator

Anterior Cervical Discectomy and Fusion (ACDF) is a surgical procedure aimed at relieving spinal cord or nerve root pressure in the cervical spine, which can cause pain, weakness, numbness, and tingling. Here's a concise overview: **Procedure:** 1. **Incision:** A small cut is made at the front of the neck. 2. **Access:** The surgeon moves aside the neck structures to reach the damaged disc. 3. **Discectomy:** The damaged disc is removed to relieve pressure on the nerves or spinal cord. 4. **Fusion:** A bone graft is placed in the disc space, and a plate with screws may be attached to the vertebrae to provide stability. **Benefits:** - Direct access to the problem disc. - Less postoperative pain compared to posterior approaches. - High success rate for relieving arm pain and improving neck pain. **Risks:** - Infection - Bleeding - Persistent pain - Complications from anesthesia - Bone graft issues **Recovery:** - The surgery typically takes 1-4 hours. - Patients may experience immediate relief from symptoms. - Recovery times vary; some patients may return to normal activities relatively quickly. ACDF is commonly performed for conditions like symptomatic cervical herniated disc, cervical degenerative disc disease, and to remove bone spurs caused by arthritis¹²³. For personalized advice and detailed information, it's essential to consult with a healthcare professional.. Source: Conversation with Bing, 24/03/2024 (1) ACDF: Anterior Cervical Discectomy and Fusion | Spine-health. https://lnkd.in/gJsF5UyQ. (2) ACDF Surgery: Success Rate and What to Expect After Surgery - Healthline. https://lnkd.in/gFPikjCE. (3) ACDF (Anterior Cervical Discectomy & Fusion) Surgery - Cleveland Clinic. https://lnkd.in/ghhWEb_q. (4) en.wikipedia.org. https://lnkd.in/gBnX-pv8.

🌍 METRUM CRYOFLEX leading in post-operative pain management globally! One of the most severe pain experiences is post-thoracotomy pain. Our innovative approach is transforming the way this pain is treated. By freezing the nerves during surgery, we effectively block pain impulses, reducing the need for opioids by up to 70% and lowering the risk of chronic post-operative pain by up to 40%. Our solutions not only improve the quality of life for patients but also shorten hospital stays, thus reducing healthcare costs. Cryoanalgesia is a breakthrough towards more efficient, safe, and patient-centered care. Our mission is to challenge the pain every day. Go Cryo! METRUM CRYOFLEX is at the forefront of this field – our technology is being applied globally, providing relief to patients and setting new standards in pain management. #Cryoanalgesia #MetrumCryoflex #PostoperativePain #PainTreatment #ThoracotomyPain #GoCryo

Meet a new approach to acute postoperative chest wall pain treatment ❗ Post-thoracotomy pain (experienced by patients who have undergone surgery) is considered to be one of the most severe pain sensations. Intraoperative application of #Cryoanalgesia prevents postoperative pain. The purpose of cryoanalgesia is to temporarily freeze and defrost a fragment of the intercostal nerve in its dorsal course. Active freezing and passive defrosting of the nerve is followed by blocking the transmission of pain impulses originating from the thoracotomy area. Even though the nerve regenerates quickly, it takes several months for the nerve impulses to be transmitted again. By using cryoanalgesia we reduce the patient's risk of chronic post surgical pain (CPSP). The application of intraoperative cryoanalgesia also has a positive impact on the costs associated with the patient's postoperative hospitalisation, as the patient's recovery period is shorter thanks to cryoanalgesia. Severe, persistent postoperative pain is very often one of the causes of extended hospitalisation period or readmission of a patient. Thoracoscopy + Cryoanalgesia ✔️ up to 7️⃣ 0️⃣ % less need for opioids ✔️ up to 4️⃣ 0️⃣ % lower risk of chronic postoperative pain ✔️ reduction of hospitalization ✔️ improvement of quality of life #paintreatment #thoracotomypain #cryoanalgesia #postoperativepain #metrumcryoflex #gocryo #thoracoscopy Check out ⤵️ ⤵️ ⤵️

Ophthopedia Update:Patient-Reported Outcomes for Minimally Invasive Glaucoma Surgery: Glaucomatous disease is amongst the most common causes of worldwide blindness, but the impact on patients varies and is associated with a plethora of factors. Most importantly, the proportion of those with the disease who experience symptomatic vision loss is relatively small compared to those with conditions such as age-related macular degeneration and diabetic retinopathy.1 Primary Open Angle Glaucoma is uncommonly visually disabling in the mild to moderate stages, and thus treatment of those at the milder end of the spectrum has been focused on non-surgical lowering of intraocular pressure. #Ophthalmology #Ophthotwitter #Scicomm

A Multidisciplinary Approach to Duodenal Stenosis: • Surgery and NSAID complications necessitate a careful strategy. • fcSEMS can be an effective, temporary intervention. • Multidisciplinary discussions are key to decision-making. Read about the collaborative approach to treatment at https://lnkd.in/e7PvwYnD