BVHS Weekend Column: I Want This Hair Gone!

Laser hair removal is one method of hair reduction that has more permanent results…..

I Want This Hair Gone!, by Lorie Thomas, DO
Blanchard Valley Obstetrics & Gynecology

There are many options available for hair removal. People will use chemical depilatories, electrolysis, shaving or wax to remove hair. A less painful option may be sugaring as well as laser hair removal for a more permanent hair removal option.

Dr. Lorie Thomas

 

Any area where you may have undesired hair is an option for hair removal. A few popular examples for men are shoulders, back, upper arms and nape of the neck. Women will often treat underarms, lip and chin, lower legs, bikini and Brazilian. Less common areas may be stomach, fingers, toes and ears. The cost is based on the area as well as whether it is a package of one, three or six treatments. Treatments are generally spaced out six to eight weeks depending on the site being treated.

Anyone can have laser hair removal including men, women and teens as long as a parent is present to sign consent.

For most people, hair removal will take up to six treatments. Treatment sessions can be as quick as 15 minutes (for lips) or as long as one to two hours (full legs/back).

Laser hair removal is one method of hair reduction that has more permanent results. Laser is a form of concentrated light that targets the hair follicle below the surface of the skin. Intense heat from the light is meant to permanently damage the hair follicle.

Hair removal has significantly improved and has minimal sensation. Many treatment modalities in the past were uncomfortable to the point of felling a “rubber-band like” snap feel at the surface of the skin. Most clients will say they feel a “prickly” sensation or warmth that is more noticeable where hair is more concentrated.

When a procedure is performed, the area to be treated needs to be clean and shaved prior to the treatment. The area to be treated will have a thin layer of gel applied and the laser handpiece will be applied and most often will gently slide over the area of treatment.

After the treatment most people will feel a warm sensation in the treated area. Some may feel like a sunburn in the area and the skin may be red afterward. The redness for most people will be nearly gone by the time they leave the treatment center. The skin should be protected from UV rays after so many choose to do hair removal before and after summertime. Rare complications may occur which include burning, blistering, swelling, redness, scarring, infection and changes in skin color such as darkening or lightening. If an individual is prone to cold sores/herpes lesions in the area of treatment, we would suggest pre-treatment with their anti-viral medication to prevent a sore from developing.

How long results are expected to last all depends on the degree of damage to each follicle during a treatment. Each treatment is meant to damage the follicle and most to the point of inability to grow the hair. During a treatment we must also take into consideration skin types and be cautious with the settings to prevent the complications or injure the surrounding skin.

To get started, schedule a consult with a physician. During the consult your medical history will be reviewed to assure that laser hair removal is appropriate for you.

 

 

 

Blanchard Valley Health System Limits Visitation

Effective March 25, 2020…

Due to community concerns surrounding the COVID-19 pandemic and to ensure that every precaution is being taken to prioritize the safety of our patients, Blanchard Valley Health System will no longer allow visitors. (Effective March 25, 2020)

This policy applies to all BVHS facilities including hospitals and outpatient clinics.

An exception of one caregiver per patient for the duration of the hospital stay will be granted for patients in our pediatric and labor and delivery care units. All surgical patients will be required to have one responsible adult support individual present. Inpatient areas and Emergency Room patients under the care of end-of-life services will be evaluated on a case-by-case basis.

At Bridge Hospice Care Centers, only four visitors will be allowed per patient per day. No visitors under 10 years of age. Visitors 10 to 16 years of age must be accompanied by an adult. They also must be able to comply with wearing protective equipment and are only permitted to stay one hour in each 24-hour period. Other situations will be evaluated on a case-by-case basis.

All approved visitors will be required to submit to a screening upon entry and wear a visitor’s badge while in any BVHS facility.

Blanchard Valley Health System Establishes Second “Triage & Testing Center”

Symptoms of COVID-19 include cough, shortness of breath, fever of 100.4 degrees or greater and fatigue……

Blanchard Valley Health System has established a second COVID-19 “Triage & Testing Center” on the campus of Bluffton Hospital, located at 139 Garau Street, Bluffton. If a patient believes they are experiencing symptoms of COVID-19 they should call the 24-hour, seven days a week, triage line at 419.369.2399 to initiate pre-screening efforts.

If patients meet specific criteria guidelines provided by the Ohio Department of Health, they will be scheduled for testing. The Bluffton Hospital “Triage & Testing Center” will only be evaluating patients who have scheduled appointments.

Symptoms of COVID-19 include cough, shortness of breath, fever of 100.4 degrees or greater and fatigue.

 

“The COVID-19 situation is constantly evolving, and we understand residents may have many questions. Our healthcare system is working hard to provide the public with needed resources,” emphasized Nicole Keuneke, director of operations at Bluffton Hospital. “We are committed to caring for our community.”

 

BVHS continues to remain aligned with the Center for Disease Control (CDC) and Ohio Department of Health. For additional guidance during the COVID-19 pandemic, BVHS continues to update information that can be found at bvhealthsystem.org under the COVID-19 tab. 

BVHS Weekend Column: The Unicondylar Partial Knee

In patients with only limited knee arthritis, surgeons may elect to perform a partial knee replacement….

The Unicondylar Partial Knee, by Stanislaw Dajczak, MD, Blanchard Valley Orthopedics & Sports Medicine
Dr. Stan Dajczak

The unicondylar partial knee implant is a partial knee implant designed to repair only one side of the knee (the medial side), making it much smaller than a total knee implant.

In patients with only limited knee arthritis, known as medial compartment arthritis, surgeons may elect to perform a partial knee replacement. Unlike total knee replacement that removes all the knee joint surfaces, a partial knee replacement replaces only one side of the knee joint. Some advantages of the unicondylar partial knee replacement are that it removes 75% less bone and cartilage, is less painful, enables a more rapid recovery and provides more natural motion when compared to a total knee replacement. By retaining all of the undamaged parts, the joint may bend and function more naturally.

Knee osteoarthritis usually occurs first in the medial (inside) portion of the joint. In knees that are otherwise healthy, a partial knee implant procedure can preserve the healthy bone, cartilage and ligaments, potentially preventing or delaying the need for total knee replacement.

Some unicondylar implants, have a fully mobile bearing partial knee system available. Research has shown that partial knee replacements with moveable plastic bearing have low wear rates, potentially giving them even longer life expectancies. The free-floating nature of the device potentially provides for a more natural feeling knee and more natural motion. In a healthy knee, the meniscus serves as a shock absorber between the ends of the bones. The artificial meniscal bearing is designed to glide freely the knee’s range of motion, more closely replicating normal movement.

Published long-term clinical results on unicondylar partial knee implants demonstrated a 98% success rate at 10 years and 95% at 15 years and beyond, equaling the results of the most successful total knee replacement thus far.

Not all patients are candidates for partial knee replacement. You should discuss your condition and treatment options with your surgeon. All provide the option of minimally invasive surgery.

 

 

 

 

Blanchard Valley Health System Establishes “Triage & Testing Center”

The BVHS “Triage & Testing Center” will only be evaluating patients who have scheduled appointments.

Blanchard Valley Health System has established a 24-hour, seven days per week COVID-19 “Triage & Testing Center” on the main campus of Blanchard Valley Hospital, located at 1900 South Main Street, Findlay. If a patient believes they are experiencing symptoms of COVID-19 they should call 419.423.7890 to initiate pre-screening efforts.

If patients meet specific criteria guidelines provided by the Ohio Department of Health, they will be scheduled for testing. The BVHS “Triage & Testing Center” will only be evaluating patients who have scheduled appointments.

Symptoms of COVID-19 include cough, shortness of breath, fever of 100.4 degrees or greater and fatigue.

 

According to Dr. William Kose, vice-president of special projects, Blanchard Valley Hospital nurses and laboratory personnel will be on-site to assist patients and conduct testing.

 

“We want to emphasize to the community that the COVID-19 testing is by appointment only,” Dr. Kose stated. “We are working together to provide quicker and more convenient access to testing so we can better protect our community.”

 

For additional guidance during the COVID-19 pandemic, BVHS, Hancock County Public Health, the City of Findlay and Hancock County leaders have developed the Hancock County Community Call Center. The number is 419.425.9999. This hotline will provide community members with information on local resources (meal delivery, childcare options, etc.) and answer COVID-19 general questions. Information can also be accessed by visiting HancockHelps.org.

Eating Right

March is National Nutrition Month….

Eating Right, by Julie Russell, RD, LD, CD, Outpatient Dietician/Diabetes Educator, Blanchard Valley Diabetes Center

Julie Russell, Dietician

March is National Nutrition Month and this year’s theme is “Eat Right, Bite by Bite.” Sometimes it can be overwhelming with what to do first when you want to change your eating habits. Simply start by trying to eat more variety. You can focus on one food group at a time. For example, think about some different vegetables or fruits you’ve never tried before. Try to pick out vegetables and fruits that are in season to get the best flavor and the lowest cost.

Another way that can help get more variety is by planning out meals or snacks. You can decide if you want to plan out meals for the week or a few days. Think about the food groups: lean meat/ protein, whole-grain, vegetable, fruit and low-fat dairy when planning your meals. Once you decide on the meals, then use that as guide to make your shopping list.

Another idea is checking the grocery advertisements to see what lean protein, fruits and vegetables are on sale for the week and plan your meals that way. Looking through healthy recipes are another great way to get ideas of how to prepare new foods. Just remember every little change towards eating healthier makes a difference!

 

Blanchard Valley Health System Limits Visitation

At this time, there have been no changes to scheduled appointments….

In the wake of the current healthcare climate, Blanchard Valley Health System (BVHS), will be limiting visitation to all areas of the organization. The new guidelines allow for one visitor per day per patient. No children (under 16 years of age) will be permitted to enter patient care areas.

BVHS is closely monitoring the Coronavirus outbreak and working with the Hancock County Department of Health, Ohio Department of Health, and following guidance from the Centers for Disease Control and Prevention (CDC).

 At this time, there have been no changes to scheduled appointments. However, this is continuously being evaluated. For general questions about the Coronavirus please call the Ohio Department of Health at 1.833.4ASKODH (1.833.427.5634). For all personal health-related questions, please contact your primary care provider.

 

BVHS Weekend Column: Distal Biceps Ruptures

Distal biceps ruptures can occur in both men and women technically at any age, however, they more often happen to men between the ages of 30 and 50…..

Distal Biceps Ruptures, by  James Davidson, MD

James Davidson, MD, Blanchard Valley Orthopedics and Sport Medicine


The biceps muscle is a key player in the function of the upper and lower arm, therefore, when it has an injury, it can make a significant impact on a person’s function. A distal biceps rupture is the tearing of the biceps brachii tendon from its attachment site. The biceps brachii or “biceps” muscle is located on the front of the humerus (upper arm). It functions to help the shoulder lift the arm forward (flexion), bend the elbow bringing the hand towards the face (flexion), and twist the forearm so the palm is towards the sky (supination). These actions are important for activities such as lifting objects, shutting doors and twisting objects back and forth (doorknobs and screw drivers).

The biceps brachii muscle splits and originates from two origins: short head attaches to the coracoid process (bony projection off of the front of the shoulder blade) and the long head attaches to the top of the glenoid labrum (cartilage ring around the socket). The distal insertion or attachment is to the tuberosity of the radius bone. The radius is one of two bones of the forearm and it is the one on the thumb side, or lateral side (outside). The tuberosity of the radius is a thicker part of the bone close to the elbow. A rupture can cause pain and physical limitations. For this article, the focus will be on distal biceps ruptures or detachments from the radial tuberosity.

The patient is often lifting something too heavy starting with their elbow in extension going into flexion (straight to bent), possibly awkwardly and/or too rapidly. They could also be catching or resisting a falling heavy object causing a distracting injury to the biceps. Patients hear or feel a “pop” which is the tendon detaching from the bone either partially or fully. This is then followed by soreness and weakness. The person will also notice tenderness, swelling and bruising over the biceps muscle. A telltale sign of a biceps rupture is the “Popeye deformity.” When the biceps tendon ruptures, it immediately starts to retract or shrink away from its attachment site causing a bulge or enlargement of the muscle belly and a divot where the tendon used to be. This mimics the look of the classic cartoon character Popeye’s exaggerated biceps muscles.

The best early first aid treatment is ice, sling and getting into your orthopedic provider as quickly as possible for confirmation of diagnosis. Confirmation of strain, partial rupture or full rupture and length of retraction is typically done with physical exam and magnetic resonance imaging (MRI). The longer the delay in diagnosis and treatment, the poorer the outcome. The treatment of choice for a larger partial or full biceps rupture in an active individual is surgical repair, IF it can be done less than five weeks from injury. An ideal timeframe would be two weeks from injury. As stated before, when the tendon ruptures, it retracts and the longer an individual waits, the less likely it can be repaired.

Aside from avoidance, the best thing for a patient is early detection and referral. Surgical repair is reattachment of the distal end of the bicep’s tendon to the radial tuberosity with suture anchor and washer. More delayed presentations to the surgeon can sometimes be repaired with sterile cadaver graft tendons, but that is not the first treatment of choice. The recovery is typically 12 weeks for heavy duty laborers.

Katie Fultz, PA-C, Blanchard Valley Orthopedics and Sport Medicine

There is a nonsurgical treatment alternative for patients with strains, low grade partial tears, chronic tears or patients who cannot tolerate a surgery which is living with the ruptured tendon. The patient will undergo physical therapy to try and regain as much function as possible. To a varying degree, the patient may notice some weakness in shoulder flexion and forearm supination. Several different factors are taken into consideration when choosing the right treatment option for a patient with a distal biceps rupture such as age, activity level, length of time from injury, extent of tear and hand dominance, to name a few.

There are ways to avoid this injury such as keeping the body strong and flexible for the type of physical demands of a person’s job and the lifestyle they lead. Good body mechanics is also key to avoidance. Avoiding rapid awkward lifting of too much weight or trying to catch an object awkwardly can keep a person from overloading their biceps. If a person already has shoulder or elbow pain, they could be more vulnerable to an injury such as a distal biceps rupture. Getting those symptoms addressed earlier could avoid future overuse or repetitive task injuries.

 

 

 

BVHS Weekend Column: Seeing a Psychiatrist

If you or a loved one are struggling through life, forget the stigma and seek help….

Seeing a Psychiatrist  by Christian Steiner, MD, Psychiatric Center of Northwest Ohio

Dr. Christian Steiner

 

“Who sees a psychiatrist anyway?” This is a common question I have been asked by many different people outside of my office. Many times, this question is brought up to me in social situations where the topic of mental health arises in passing. I often forget that psychiatry has a stigma as every day I encounter people from all walks of life who are seeking professional help for an array of different issues.

As I live in the community which I practice in, I do often encounter patients in the community and out of respect for confidentiality, I may give a simple “Midwest nod” of greeting but most times, I simply go on about my business. If I had not provided care to that person, I never would have known they were having issues or struggles. I think that if we were to simply take a sample of population and had others try and “pick the one who sees a psychiatrist” most would be quite incorrect.

I often tell others who ask, “who sees a psychiatrist anyway?” that, it’s not always what you think. Of course, I have done work with those who are homeless, hear voices and cannot care for themselves but surprisingly, this is not a typical presentation of a psychiatric patient. Most times, people are seeking help as they feel overwhelmed with emotions that despite their own effort, beliefs and work, cannot be calmed or stabilized. These are people who do walk among us and live successful lives, are our neighbors, co-workers or even family.

Unfortunately, suicide is now the 10th leading cause of death in the United States and amongst teenagers; suicide just surpassed cancer and is the third leading cause of death. All too often we hear of a person who committed suicide “we never knew” or “they seemed so happy I couldn’t tell they had a problem.” Unfortunately, part of the reason we never knew is due to the stigma associated with seeking help. If you or a loved one are struggling through life, forget the stigma and seek help.

 

BVHS Weekend Column– Egg Allergy and the Flu Shot: Cause for Alarm?

Multiple studies conclude that it is safe for people with life-threatening egg allergy to receive flu vaccines……

Egg Allergy and the Flu Shot: Cause for Alarm? by Amber Patterson, MD
ENT & Allergy Specialists of Northwest Ohio

Dr. Patterson

 

If you have egg allergy you may have been told to avoid flu shots or other vaccines due to concern that the vaccines may contain egg. Many vaccines are produced or grown in hen eggs. By harvesting vaccines from eggs, a theoretical risk presents itself. What if there is active egg protein in the final vaccine product? Multiple studies conclude that it is safe for people with life-threatening egg allergy to receive flu vaccines. 

The theoretical concern is not a real risk. However, the myth of egg allergy as a contraindication for receiving the flu shot persists in the public. A national allergy guideline update specific to this question was published in 2017 and included the following recommendations (Greenhawt, 2017).

  1. Flu vaccines should be administered to those with any severity of egg allergy, just as they would to someone without egg allergy.
  2. No special precautions are necessary. Individuals with egg allergy receiving a flu vaccine should be shown the same general precautions as with the general population.
  3. It is not necessary or preferred to use flu vaccines manufactured without egg exposure over traditional flu vaccines grown in hen egg.

While these are not new guidelines or recommendations, they deserve repeating to ensure that egg allergic individuals receive the same care and influenza prevention treatment as the general population.

 

BVHS Weekend Column: Rotator Cuff Tears

These muscles are deep and attach at the upper part of the arm…..

Rotator Cuff Tears, by Stanislaw Dajczak, MD, Blanchard Valley Orthopedics & Sports Medicine

Stanislaw Dajczak, MD

 

A rotator cuff is a group of four muscles that help move the shoulder. These muscles are deep and attach at the upper part of the arm. Deep muscles attach to the bones around the ball-and-socket joint by a thick, non-elastic tissue called a tendon. These tendons can tear by an acute injury or degeneration over time and can occur in any of the four tendons. Rotator cuff arthropathy is defined as arthritis as the result of tearing these rotator cuff tendons.

 

What are the causes?

Rotator cuff tears have many causes. Intense trauma, longstanding impingement syndrome (caused by injury on the acromion or bone spurs at the acromioclavicular (AC) joint), repetitive overhead activities, and degeneration in the older population are all common. When the tendons are detached from the bone, the shoulder can become dysfunctional. Pain is then associated with moving of the arm and motion eventually decreases if the tendons are not repaired back to the bone.

 

What are the symptoms?

Rotator cuff tears cause pain, particularly on the side of the shoulder and at night, leading the patient to believe they slept wrong on their shoulder. Subacromial bursitis, a condition of pain and tenderness during arm motion, typically accompanies rotator cuff tears. Depending on the severity and location of the tear, loss of motion and strength can occur in a specific plane. This may be lifting the arm to the side, overhead or behind the back. Activities of daily living like reaching up to a cupboard, reaching for a wallet in a back pocket, brushing your hair or fastening a bra may be severely impacted when a rotator cuff tear is present.

A massive tear of more than one tendon may result in “pseudoparalysis,” an inability for the patient to move their arm away from their body. Pain may also radiate up the shoulder to the neck, as the patient attempts to move the shoulder using other muscles. If the tendons remain torn for an extended period of time, the ball does not stay centered in the joint, causing wear and tear to one or both sides of the ball-and-socket joint.

 

How is it diagnosed?

Your surgeon will perform a thorough history and physical exam including X-rays. Exam findings will consist of loss of active range of motion (you move your arm), preserved passive range of motion (the surgeon moves your arm), and weakness and pain with muscle testing. X-rays may or may not demonstrate abnormalities of the acromion, the projected part of the shoulder blade, or AC joint bone spurs that may be causing impingement (the tendon rubbing) of the rotator cuff. Superior or anterior movement of the humerus (ball) on X-ray is a sign of a chronic rotator cuff tear that may not be amenable to repair (also known as superior or anterior escape). A magnetic resonance imaging (MRI) is useful to quantify the size, severity and age of the tear. For patients who cannot have an MRI, a CT/”CAT” scan with contrast dye may be helpful in assessing damage to the rotator cuff.

 

How is it treated?

Non-operative

The extent of the arthritis, long term damage to the tendons and muscles, function of the shoulder, amount of pain and patient factors (age, health issues like diabetes or seizure disorder, tobacco use and activity level) all influence the treatment of rotator cuff arthropathy. Non-operative treatment can be attempted but once the diagnosis of rotator cuff arthropathy is made, is not usually helpful. Physical therapy, anti-inflammatory medication, cryotherapy, activity modification or injections into the space just above the rotator cuff may alleviate pain and inflammation. Patients whose pain does not resolve with non-operative treatment should discuss surgical treatment options with their surgeon.

 

Operative

Patients who have a chronic, irreparable tear in the rotator cuff but have minimal to no arthritis, several minimally invasive arthroscopic procedures can be performed for pain relief. An arthroscopic CAM procedure, also known as a debridement or “cleanout,” can remove inflammatory tissue, remove bone spurs and treat biceps tendon injury/inflammation. An arthroscopic superior capsular reconstruction (SCR) uses donor tissue to realign the ball-and-socket joint and restore some of the mechanics that are affected by chronic rotator cuff tendon tears. Both of these procedures may decrease pain, but restoration of function is patient dependent. For more advanced rotator cuff arthropathy, reverse total shoulder arthroplasty (rTSA) can be performed for pain relief and restoration of some function. In rTSA, your surgeon can remove the arthritic areas of the ball-and-socket joint and replace them with metal and plastic components. In this procedure, the ball-and-socket components are switched, so that the ball becomes a socket and the socket becomes a ball, allowing the shoulder to move pain-free and using other muscles in lieu of the rotator cuff. Your surgeon will discuss all of your options based on the severity of damage in your shoulder.