Health & Wellness

Health & Wellness

Hospital Stays and Shoulder Surgery


Ask the Orthopedist



Is it possible to have shoulder replacement surgery as an outpatient procedure?


Yes. Orthopedic surgeons who specialize in shoulder surgery are now providing patients with the outpatient option when it applies to their condition. People love the outpatient experience and recover better when they are at home.

When provided by a specialist, the surgery may only take 35 minutes in a highly controlled environment and results in little blood loss. The less time that you are under anesthesia, the better the recovery. There is less risk of infection, increased patient satisfaction and higher quality outcomes based on function and pain with a home recovery. Patients walk out with their arm in a sling and are home the same day.

In the weeks leading up to surgery, each patient and their caregiver should be provided with educational information and a prescription for physical therapy. For example, our practice offers a series of physical therapy videos that patients study before the surgery and work on at home post-surgery. The videos illustrate the exercises, and the education offers very specific goals that each patient needs to meet to recover faster.

The outpatient surgery and home rehabilitation option saves patients considerable time and money. Most patients are able to use their arm enough to care for themselves within a week after the procedure. After three months of follow-up appointments, the patient no longer requires office visits, but the atrophy from the initial injury could take up to a year to fully improve.

While a large percentage of patients are candidates for outpatient shoulder surgery, it’s not for everyone. Patients with complicated medical histories may not qualify. Each patient should be carefully examined to determine the procedure that will work best for them.

All shoulder conditions should be evaluated by a shoulder specialist with a thorough history and physical examination including imaging studies.

Read more 0

ADHD – Adults Can Have It, Too


No Kidding — Adults Can Get It, Too


By Paris Wolfe


When Lisa, 55, of Cleveland was treated for ADHD (Attention Deficit Hyperactivity Disorder) this year, she felt like a new person. Her productivity improved, she slept better and life became more manageable.

“I couldn’t believe the difference,” she says. “(Medication) helped me focus instead of bouncing off walls. Before, I would be working on something and be distracted by the next shiny thing that came along. Then, I’d get anxious because I would get behind on the first project.”

That anxiety snowballed and may have caused depression. Once the ADHD was addressed, her depression and problems seemed to melt away.

An Adult Diagnosis

Before a comprehensive five-hour series of tests diagnosed Lisa, she didn’t realize adults could be affected. Like many, she thought ADHD was just for kids.

Not so. ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, according to the National Institute of Mental Health.

Research suggests it persists into adulthood for at least 50 percent of those diagnosed as a child. As many as 10 million adults may be affected.

People in their 50s and 60s fall into those numbers. ADHD didn’t suddenly appear with Generation X. Despite the lack of diagnoses, it has been around for a long time, spanning generations. While causes aren’t definitive, studies attribute ADHD to genetics as well as to smoking and drinking during pregnancy.

Symptoms may be less apparent in the over-50 population because they’ve had longer to learn coping skills and life hacks.

One of the most common ways adults realize they’re affected is during an exam of a child or grandchild.

“They sit in the room with the provider who asks questions about the child, and the adult starts to see the light.

Read more 0

The Cleveland Eye Clinic

Dr. Daniel Pierre and The Cleveland Eye Clinic Introduce Breakthrough Treatment for Eye Floaters

The Cleveland Eye Clinic has announced the introduction of Laser Floater Removal, a highly effective treatment for floaters.  A minimally invasive, in-office procedure, Laser Floater Removal can provide much-needed relief for floaters and potentially delay or obviate the need for vitrectomy surgery. Floaters are small pieces of debris that float in the eye’s vitreous humor (the jelly-like substance in the main chamber of the eye).  Often described as cobweb or cloud-like shadows, this debris casts shadows onto the retina (the light sensitive tissue layer at the back of the eye).  Almost everyone over the age of 70 has floaters.

Daniel Pierre, M.D., of the Cleveland Eye Clinic, was the first doctor in Ohio to perform Vitreolysis.   Dr. Pierre describes the new YAG laser used for Vitreolysis as “the newest generation YAG laser that enables this procedure to be done safely and efficaciously. Previous treatments were more difficult, less safe and less effective.”

Laser Floater Removal employs a specially designed YAG laser to vaporize floaters.  During the procedure, the laser emits a short burst of energy lasting only 3 nanoseconds (0.000000003 seconds). Instead of simply breaking the floater into smaller pieces, the laser’s high-power density converts the collagen and hyaluronan molecules within the floater into a gas, which is then resorbed into the eye.

Unlike vitrectomy, which carries a significant risk of bleeding and infection, Laser Floater Removal is minimally invasive and carries a very low risk. Most patients will experience an almost immediate improvement in visual function and are able to return to normal day-to-day activities directly following the procedure.  “We are excited to be among one of the first clinics in the United States to offer laser Floater Removal,” says Dr. Pierre.

“Typically, many of my patients describe floaters as ‘strands’ or ‘blobs’ obstructing their line of vision.

Read more 0

Hand Help

Ask the Orthopedist

Not Very Handy


Carpal Tunnel and Arthritis Pain


By Scott M. Zimmer, MD




Is the pain in my hand and wrist carpal tunnel or arthritis?




Carpal tunnel syndrome and arthritis of the hand and wrist are two of the most common complaints I see as a hand and upper extremity surgeon. There are some common overlapping symptoms — such as pain and aching with gripping — but the two conditions are vastly different.


Carpal tunnel syndrome occurs when there is increased pressure on the nerve that gives sensation to most of the hand except your small finger. Think of the nerve (median nerve) as an electrical wire carrying impulses that can be affected by external compression (such as crimping a wire). Symptoms include numbness, aching pain in the fingers and up the forearm, and pain that commonly wakes you up at night.


Arthritis, better known as osteoarthritis, is simply the loss of cartilage between the two bones that make up a joint (a joint is where motion occurs). Our joints rely on this layer of cartilage to create fluid motion and absorb shock stresses. As the cartilage wears out, increased friction triggers pain, swelling and decreased motion. It is exactly like brake pads wearing out on a car.


Differentiating these two conditions is obtained by getting a symptom history, an examination and X-rays. Numbness, tingling and night pain are hallmarks of carpal tunnel. Arthritis usually can be localized to the base of the thumb where it attaches to the wrist or in the small joints of the fingers. Deformity and swelling of the joints occurs late in the arthritis process and may not be seen early on.


Treatment Options

Treatment of both conditions starts with making the correct diagnosis, followed with specialized supportive bracing.

Read more 0



Rejuvenate Yourself

Get an Energy and Productivity Jumpstart

By Jeff Tomaszewski


Four hundred and thirty-eight million: That is the number of vacation days Americans failed to take last year, more than any other industrialized nation, according to Harris Interactive Research Group.

Here’s the result: America ranks first in both depression and mental health issues.

Americans are burned out. Our productivity and creativity are dropping, relationships are failing and our rising stress is leading to record levels of heart disease, stomach ulcers and depression.

All Work, No Play

We’re judged by how much we work. We’re afraid of being replaced or left behind, and we’re addicted to busyness. It’s not only destroying our mental and physical health but also our creative productivity.

This is especially true in our global economy, where our future lies with our ability to think creatively, innovatively and productively.

Rest and recovery are vital to looking and feeling your best. Unfortunately, it’s viewed as a weakness rather than as an integral aspect of growth and sustained performance.

We become flatliners mentally, emotionally and physically by endlessly spending sufficient energy without recovery. We slowly wear down and become ineffective.

Taking a break might be difficult for some of us. Consider these tips:

Reframe it: Instead of calling it time off and thinking we are slackers, reframe it as “rejuvenation time.” This sounds more purposeful and meaningful, doesn’t it? This might be mental manipulation, but we’ll take whatever works.


Schedule it: What gets scheduled gets done. Like any critical appointment, you have to plant your time-off flag on your calendar and defend it. Take a break from email. Put your phone and other electronic devices aside.


Declare it: Don’t feel guilty or try to keep it a secret. Lead by example and show others how to make rejuvenation part of an overall health plan.

Read more 0




Replacing Lost Teeth

Dental Implants

By Dr. Steve Marsh


Missing teeth not only detract from your smile, but they can also make you feel uncomfortable.

If you have lost one or more teeth, you should know about dental implants — a technique for restoring the look and feel of natural teeth. Dental implants are extremely successful and quite popular. They can look and feel just like getting your real teeth back.


From the Root Up

You could say that a dental implant replaces your missing tooth from the root up. The first of the three steps required to replace a lost tooth with a dental implant is getting an artificial “anchor” for your missing tooth’s root.

Tiny titanium fixtures (screws) are placed in your jawbone by a specialist or general dentist. Either local or general anesthesia can be used. Very gentle, low-speed placement protects the bone tissue and promotes healing.

Finishing touches

Three to nine months later, the living bone in your mouth has bonded permanently with the dental implant, and it’s time to go to the next step.

The dentist attaches a post to the dental implant. Finally, a crown, bridge or anchored denture can be attached to the post. This replacement tooth will have been carefully shaped to fit in perfectly with the rest of your teeth.

When done properly by a skilled cosmetic dentist, the result is a totally natural-looking smile with strong teeth that you can be completely comfortable with.

Patients tell us they are able to eat foods they avoided before, and are smiling naturally and speaking more clearly.
Dr. Steve Marsh serves patients throughout greater Cleveland. He does all cosmetic dental procedures, including dental bonding, porcelain veneers, teeth whitening, implants, ceramic fillings crowns and bridges, and extreme dental makeovers. Contact him at

Read more 0

The Value of Play

Recess for Grown-ups

Up Your Play Game


By Estelle Rodis-Brown


“All work and no play makes Jack a dull boy.”


As it turns out, this old proverb rings true, far into adulthood. Too much work and not enough playtime can damage your attitude, your social life and — in full circle fashion — even your productivity. So put play to work for you.


Do You Play?


Our society tends to reject play for adults. Play is considered unproductive, petty, even a guilty pleasure. Adulthood forces us to get serious and set aside childish ways. Between personal and professional responsibilities, there’s no time to play anyway — or so we think.


However, play is just as important for adults as it is for kids, and it should not be neglected. Play brings joy and rejuvenation. It’s also vital for problem solving, creativity and relationships.


In that case, what qualifies as play? Kathryn Orantek is the personal training coordinator for health, physical education and recreation programs at Lorain County Community College. She says, “Play is any activity, structured or unstructured, that allows adults to let go of their inhibitions, forget about the outside world and just have fun.”


Considering her background in health and wellness, Orantek “would love to see people spend more time engaging in physical activity while playing, but I suppose you could apply it to games, coloring, puzzles and such.”


No Goal? That’s the Idea


Play is a state of being that’s purposeless, fun and pleasurable, psychiatrist Stuart Brown, M.D., says in his book “Play.”


The focus is more on the experience than on accomplishing a goal. Play can be art, books, movies, music, comedy, flirting and daydreaming, says Brown, who founded the National Institute for Play.


Ultimately, play is a process that stirs up surprise, pleasure, understanding and strength of mind, body and spirit.

Read more 0

Dr. Francoise Adan discusses Stress Reduction best practices

Dr. Francoise Adan

Center for Lifelong Health at University Hospitals

From Golden Opportunities – April 2, 2017 (Show #837)

Read more 0