Making an Apple Watch Birthday Cake

Apple Watch Birthday CakeTalking about baking the Apple Watch birthday cake, Dr. Grossfeld explains that she really only bakes once a year outside of an occasional batch of cookies and apple or cherry pie.

I wouldn’t even come close to calling myself a baker. I also start with the mindset every year a couple days before Adam’s birthday that baking cake can’t be much more technical than performing a rotator cuff repair and I can perform a great rotator cuff repair.

Discussion of the process:

The birthday cake making process started with going to Google Images and searching “apple watch cake.” Dr. Grossfeld explains:

I found several ideas that I combined. The next step was finding the best recipe. By googling “best moist chocolate cake” I found what sounded like the perfect recipe plus it had an icing recipe attached. See below for both recipes. When making the cake I applied similar principles that I use in the operating room . For example, mixing all the ingredients is just like mixing the cement used in a total knee or hip replacement.

Adam and my husband are dark chocolate fans so I substituted Dark Hershey’s chocolate for the regular chocolate cocoa that was recommended.

Still not 100 percent sure how I was going to fashion and piece the apple watch birthday cake together while I was mixing the ingredients I decided that more baked cake to work with would be better. So I doubled the recipe for the cake and the icing. Once the cakes were baked I got out my Apple Watch and looked it very closely trying to decide what were the distinguishing feature of that watch versus any other watch.

I did not have the 9 inch cake pan like the recipe called for but had three 8×8 inch pans from the prior year’s cake so I greased and floured all three of them up. Again, because I am not an experienced baker I was not exactly sure how much batter to put in each pan without it rising as it baked to spill over the side of the cake pan. it worked out well. Sometimes it’s better to be lucky than good.

Last year was the first year I used Fondant icing . Fondant is a ready-made colored icing that can be rolled out with a rolling pin and comes in different basic colors. It has the consistency of play dough. Fondant is great for cutting out shapes and decorating the major downside is it also tastes like play dough .

As the cakes were cooling Adam and I picked out nine apps that looked like there were fairly easy to make out of the Fondant icing and were ionic to Apple . We then started the cut and paste process of using the different colored fondant and cutting tools. When purchasing the Fondant at Walmart I noticed they sold a set of relatively inexpensive cutting tools and knowing that in the operating room not having the right tool can make or break you so i tossed them into my shopping cart.

As we made the apps we glued them together with water. As they were finished I  laid  hem out on the back side of the the upside down empty center cake pan to make sure they fit properly . I tried to organize them so that the different colored apps were evenly spread out.

I then covered a larger wooden cutting board with aluminum foil and saran wrap as my base plate. The next step was to cut the different cakes up into pieces of the Apple Watch and connect them with toothpicks and the chocolate icing I made. I applied the same principles like I do in the operating room when internally fixing a fracture with hardware or applying a cast in the office. Just slightly different materials …similar basic principles.

Using Adam as my critic each step on the way on the cake construction the parts came together fairly well. The icing was applied and them the fondant apps and strips on the watch band .

The apple watch birthday cake made it successfully to the party. An unseen issue was the kids were fighting over what app they wanted as their piece of cake . No worries it was worked out successfully and everyone got their app or at least half of the app they requested.

Extreme Chocolate Cake (used to make an Apple Watch Birthday Cake) and Icing Recipe:

Recipe by: RACH56 (per the website) Thank you RACH56 you are a recipe genius!

2 cups of white sugar

1 3/4 cups of all-purpose flour

3/4 cup unsweetened cocoa powder ( I substituted Dark Hershey Chocolate powder here)

1 1/2 teaspoons baking soda

1/1/2 teaspoons of baking powder

1 teaspoon of salt

2 eggs

1 cup of mile

1/2 cup of vegetable oil

2 teaspoons vanilla extract

1 cup of boiling water

  1. Preheat oven to 350 degrees

2. Grease and flour two 9 inch cake pans

3. In a medium bowl, stir together the sugar/ flour/ cocoa/ baking soda/ baking powder and salt

4. Add the eggs , milk, oil and vanilla

5. Mix for 3 minutes with an electric mixer

6. Stir in the bowling water by hand

7. Pour evenly into the two prepared pans

8. Bake for 30-35 minutes in the preheated oven until a toothpick inserted comes out clean

9. Cool for 10 minutes before removing from pans to cool completely (more…)

What is SI Joint Pain and What Causes it?

The sacroiliac joint is responsible for connecting the sacrum bone at the bottom of the spine to the pelvis. While small, this joint is very strong as it provides stability and absorbs shock to this area. It is triangular in shape and is formed by the fusion of several vertebrae during development. You can even see these joints on the surface of your back as they look like two small dimples on each side of the lower back and above the buttocks.

The sacroiliac joint allows your hips, legs and spine to function properly without pain or added pressure. If you’re experiencing pain in this joint, it can be tricky because it is often caused by too much activity or too little activity. Usually if you feel pain in the lower back, hips and groin, this means that your SI joint is being overworked. Yet if the pain is centralized to your lower back and buttocks and travels down your leg, the SI joint pain could be caused in part by inactivity.

While too much activity and not enough activity can be causes of SI joint pain, pregnancy is also a common cause of this condition. The added pressure and weight can cause the SI joint to align abnormally. This is the reason why many pregnant women experience SI joint pain.

Symptoms of SI Joint Pain   

joint pain, lower back pain, SI joint pain

SI Joint pain is often felt in the back or buttocks. Sometimes SI joint pain radiates down one or both legs, all of the way down to the foot. This pain is often confused with a herniated disk or issues with the spine. Unfortunately, this pain tends to make sitting more difficult.


If you have been experiencing this type of lower back and buttocks pain, SI joint pain is a possibility. You should consult a qualified physician for a thorough examination and accurate diagnosis. SI joint pain is typically associated with inactivity and over-activity, so if you have recently started an intense workout program or have been sitting more than usual lately, your pain could be linked. It is best to seek medical attention with this type of pain to rule out other medical conditions and to get the treatment you need to feel better.

Your physician will complete a historical and physical exam to understand your symptoms. He or she will then check your posture and will likely examine your walking gate. You may also have lab exams or X-rays to determine whether your pain is related to the SI joint. (more…)

The Real Dangers of Concussions

Sports are a great outlet for children to be active, develop social skills, and learn the importance of teamwork. According to The Boston Globe, three out of four American families with school-aged children have at least one playing an organized sport. This is a total of roughly 45 million children. It’s important that kids are allowed to play the sports that they love, and do it in the safest way possible. Unfortunately, injuries come with the territory, and some are more serious than others. Concussions are one of the most important sports injuries to recognize.

Concussions, soccer, football, concussion symptoms

The Centers for Disease Control and Prevention defines a concussion as a type of traumatic brain injury caused by a bump, blow or jolt to the head.  Concussions may also occur during impact to the body, causing the brain to shuffle back and forth within the skull. It’s reported that about 175,000 children per year are treated for concussions due to sports-related injuries nationwide.

Common Concussion Symptoms to Recognize

Concussion symptoms come in many different forms and have serious physical, cognitive, and emotional side effects. Some common symptoms of a concussion include: pupil enlargement, drowsiness, recurring headaches and slurred speech. In addition, many people suffering from concussions experience numbness, vomiting, confusion, and even loss of consciousness.If you are a parent, coach, teacher, or some other kind of caregiver to children, it’s important that you pay close attention to your child’s behavior after an injury. If symptoms seem to worsen, take them to the emergency room immediately. You should also seek qualified medical attention if symptoms do not improve in a timely manner.

Every athlete is different, but depending on the individual and the severity of the concussion, athletes are sometimes required to wait days, weeks, or even months before returning to athletic activities.Though good treatment for concussions is available, if possible it is always best to try to avoid these risky head injuries. Follow along for 7 best practices to help avoid concussions.

7 Best Practices for Avoiding Concussions

  1. Wear the Required Gear. Wearing the right protective equipment is often the difference between a minor versus a major sports injury. Be aware of the equipment that’s needed to ensure that your child is safe.
  2. Respect the Rules of the Sport. Rules are important. Game rules are put in place for a reason and it’s important that these rules are followed. Avoid illegal hitting and/or tackles to make sure that everyone stays safe.Concussions, soccer, football, concussion symptoms
  3. Teach the Basics. The best way to avoid sports-related concussions is to know the fundamentals of the game. By mastering certain techniques, it will help the athlete play the sport correctly.
  4. Build Neck Muscles. Studies have shown that by building neck muscles you can avoid a concussion. Young athletes who practice strengthening exercises for their neck will make their head less vulnerable to injuries.
  5. Stay Hydrated. Hydration is a key component in sports. Remember that athletes who want to perform at the top of their game need to drink lots of water. There is a direct relationship between concussions and dehydration.
  6. Listen to the Child. If your child is complaining of headaches or nausea after a hit, it is very important that you listen to them. If these signs are caught early on, you can make sure your child receives the medical attention that they need.
  7. Get Educated. Both parents and coaches are responsible for educating athletes on concussions and how to avoid them.

Preventing concussions should be a priority for (more…)

New Information on Chronic Exertional Compartment Syndrome

Some athletes experience exercise related pain in the lower leg caused by chronic exertional compartment syndrome. The American Journal of Sports Medicine published an excellent article on this in May, 2016. The research, by Dr. Winkes, took place at the Maxima Medical Center in Veldhoven, Holland.

Runners, soccer players and other distance athletes may experience chronic exertional compartment syndrome. It is a condition that plagues athletes with pain, tightness, numbness and tingling. These symptoms usually occur in the lower extremities with fitness. The symptoms subside with rest. As soon as athletes start to increase their activity level such as going out for a run, the symptoms return.

Overview of Compartment SyndromeChronic Exertional Compartment Syndrome in Athletes

There are four compartments to the lower leg: the anterior compartment, the lateral compartment, the superficial posterior compartment, and the deep posterior compartment.

The anterior compartment is the front compartment of the leg and it is most commonly affected. This particular article examines patients that have high pressures or chronic exertional compartment syndrome, localized to the deep posterior compartment only.

Treatment for Chronic Exertional Compartment Syndrome

Treatment for chronic exertional compartment syndrome typically starts with rest. After adequate rest, physical therapy is often beneficial. Other things that help treat compartment syndrome include: adopting a forefoot strength running technique and shoe wear modification. Compartment pressures are tested in the office if those symptoms do not resolve with the above-mentioned treatment recommendations.

Diagnosing and Testing for Compartment Syndrome

A physician testing for compartment syndrome places a pressure catheter into the athlete’s leg in each compartment. Then the athlete will run on a treadmill and to monitor whether the pressure in the compartment increases. If the pressure increases abnormally, then the athlete has chronic exertional compartment syndrome. Some athletes have all four compartments of the leg affected. While other athletes just have the anterior compartment affected. And some athletes may just be affected in the posterior deep compartment.

Discussions and studies noted that surgical technique is not as successful when the posterior deep compartment pressure is involved.

Compartment Syndrome Research conclusion

This prospective study looks at 44 patients who have isolated deep posterior compartment chronic exertional compartment syndrome. Seventy-one percent of the patients benefited from a fasciotomy. This is a surgical technique where the surgeon goes in and releases the fascias surrounding that particular compartment. All of the study participants had deep compartment chronic exertional compartment syndrome in the lower leg. (more…)

Hip Pain During Pregnancy

Causes of Hip Pain During Pregnancy

If you’re experiencing hip pain during pregnancy, this is often completely normal. Hip pain is especially common during the third trimester. This is because your body is preparing for labor. During this time, your body release hormones that allow your connective tissues to relax, soften and expand. This allows the joints and ligaments near your pelvis to loosen and become more flexible. This is especially important for a healthy birthing experience. Additionally, many pregnant women with hip pain are sore on the side of the body where their baby tends to rest.

Sometimes lower back pain is associated with hip pain during pregnancy. As your pregnancy moves closer to full-term, you may start to notice changes in your posture. This is often paralleled by the increasing weight of your baby.

hip pain during pregnancy tips and relief

Megan is an X-ray tech with Orthopaedic Specialists. She has worked throughout her pregnancy and she is scheduled for a C-section soon. Congratulations Megan!!

While hip pain for pregnant women is common, it’s always advisable to pay close attention to your body. If you ever experience sharp, stabbing pain in your hips and lower body, you should consult a physician immediately.

Also, any lower hip pain that begins to wrap around your stomach and on either side of your body could be associated with preterm labor. It’s important to understand the difference between common hip pain symptoms and pain that could indicate other issues.

9 Tips to Ease Hip Pain During Pregnancy

And as any pregnant woman can attest, hip pain is just one of the many symptoms of pain that may come along with pregnancy. (more…)

Symptoms of the Zika Virus: An Overview

Zika Virus SymptomsFor many people living in tropical regions in Central and South America, the Zika virus has been a concern since the 1950s. Recently, the Zika virus has spread at an alarming rate. And now the virus has traveled to North America with 14 known cases in Miami, Florida in August 2016. This virus is extremely worrisome for pregnant women or those looking to become pregnant. The Zika virus causes serious birth defects in children born to a Zika infected woman.

Because of the seriousness of this virus, it’s extremely important that the public recognize Zika virus symptoms and take proper precautions. The Zika virus can spread through infected mosquito bites or through sex with an infected partner. Recognizing Zika virus symptoms is the first step to prevention with the Zika virus. It’s also important to note that although four out of five people have visible symptoms, according to Medical Daily, some people are symptom-free and unaware that they are suffering from the virus.

Zika virus symptoms are mild, but there have been extreme cases that have required individuals to be hospitalized. Most Zika symptoms last for a couple of days and for as long as a week. If you have traveled abroad recently to a high risk region, you should listen to your body and notice any unfamiliar changes that are common Zika virus symptoms.

6 Zika Virus Symptoms

  1. Headaches

    Headaches are often the first symptom that many infected people first experience. It is important to recognize the difference between your normal sinus headache and one connected with the Zika virus. Also, if your headache becomes severe to the point where you experience sound and light sensitivity, and nausea, you may want to see a physician.

  2. Rash

    According to NBC News, a Zika rash occurs in about 90 percent of those that have been infected with the virus. Usually it starts on the hands and arms and then moves to cover the whole body and down to the feet. This rash appears to include red, raised bumps that become itchy and uncomfortable.

  3. Fever

    People infected with Zika virus begin to run a fever as symptoms progress. Often the fever is mild and does not exceed 103 degrees. If your temperature increases, you will want to drink plenty of water and get some rest. As always, if your temperature is running high consistently, you will want to seek medical attention.

  4. Joint Pain

    Pain and a burning sensation in your wrists, knees and ankles is a very common symptom of the Zika virus. This sudden onset of pain and inflammation can look like arthritis symptoms. It is especially important to notice the timing of this pain, if you are returning from the U.S. after having visited a high risk region.

  5. Muscle Pain

    Along with joint pain, individuals infected with the Zika virus sometimes experience symptoms of muscle pain and weakness. This may become especially noticeable during your regular physical activities. Remember to pay attention to your body and relieve this pain by resting and icing the affected muscles.

  6. Conjunctivitis

    Itchy, red eyes that appear to look bloodshot have been reported as a common symptom of the Zika virus. If you suddenly experience this symptom, make sure you rule out allergies or times when your eyes may have come in contact with pollutants, chemicals or other substances.

If you experience any of these symptoms following international travel or sexual contact, you should seek medical attention immediately. While the symptoms are mild, it is important to identify the zika virus through a blood test. Currently there are no vaccines or medications available to treat the zika virus. You can use Tylenol or acetaminophen to help manage the pain. Do not use Ibuprofen and aspirin as they can raise the risk of bleeding. Lastly, once a person has been infected by the zika virus, he or she is likely to be protected against future infections. Scientists and health providers are still working to discover more information about the zika virus, so at this time the research is still incomplete.

For more information on the Zika virus, Zika virus symptoms, or cases of joint and muscle pain, call Dr. Grossfeld’s office at 502-212-2663.

Ruptured Tendons in Anabolic Steroid Users

Steroid Use in Bodybuilders may lead to Ruptured TendonsSteroid use is more frequent with the intense level of competition in today’s sports. For bodybuilders, the consumption of steroids allows these individuals to grow their existing muscles in size. These types of drugs help bodybuilders burn fat, gain muscle and achieve a desired body appearance for competition.

While steroid use is illegal without a doctor’s prescription, many athletes including bodybuilders are beginning to use steroids more frequently than ever before.

Common Types of Steroids Used by Some Athletes

Because of the very serious health risks involved, it’s very important for athletes and coaches to understand the physiological impact of taking steroids. There are four common types of steroids that athletes and other individuals take to strengthen and build muscles. These include:

  1. Testosterone
  2. Anabolic steroids
  3. Human Growth Hormone (HGH), and
  4. Insulin.

The types of steroids listed above produce different results and come with different side effects. All of these drugs should NOT be taken without your physician’s approval. Steroids are dangerous to individuals that abuse them.

Research on Bodybuilders and Anabolic Steroid Usage Finds Risk of Ruptured Tendons

While these different types of drugs are illegal and often result in bad side effects, it is important to address the impact of these drugs. A recent study published in the American Journal of Sports Medicine in October 2015 found that bodybuilders saw an increase in ruptured tendons while using anabolic steroids. Dr. Gen Kanayama studied 142 bodybuilders to determine the impact of steroid use in these individuals.

This group of bodybuilders were divided into two groups. They had 88 athletes that had been on the steroids for at least two years, and 54 athletes that had no history of any steroid use. What they found was quite interesting. They found that the anabolic-androgenic steroid users had a 22 percent incidence of tendon ruptures compared to only 6 percent with a non-steroid bodybuilders. The non-steroid bodybuilders tendon ruptures were in the lower extremities involving the knee or the ankle. They found that the only athletes that sustained upper extremity tendon ruptures were the bodybuilders that were taking anabolic steroids.

Overall, there was a higher incidence of tendon ruptures among steroid users. In contrast, non steroid body builders had a much lower incidence of tendon ruptures. Seventeen percent out of the 22 percent of tendon ruptures were in the upper extremity for the steroid bodybuilders. And there were no tears in the upper extremity for the non-steroid bodybuilders. (more…)

Does Undergoing ACL Reconstruction Surgery Help Your Knee in the Future?

ACL reconstruction surgery has been scientifically proven to provide more stability to your knee. This treatment option allows you to get back to your regular activities, sports and work responsibilities that may require twisting, turning and jumping.

While acl reconstruction surgery has proven to be a positive outcome to treat ACL tears, some patients decide against undergoing ACL reconstruction surgery for various reasons. This decision has sparked questions about the health of the knee over time. Do patients that undergo ACL reconstruction “protect” their knee from other future problems? Are they less likely to experience future meniscal tears, osteoarthritis, and subsequent pain?

ACL Reconstruction Surgery Research

The Mayo Clinic at Rochester, Minnesota, performed an ACL Reconstruction Surgery and Future Outcomesoutstanding study that was published in the July 2016 American Journal of Sports Medicine by Dr. Thomas Sanders. The researchers evaluated 509 patients that needed ACL reconstruction surgery.

Study participants were divided into two groups: 1) those treated with an early ACL reconstruction surgery less than a year following the injury, and 2) those that had a delayed ACL reconstruction.

From a total of 509 patients, 364 of these individuals were treated without surgery. The study spans from two months to 25 years following the initial ACL injury and treatment plan.

Researchers wanted to understand the outcomes for nonsurgical knee injury patients. They wanted to see if patients who avoided ACL reconstruction surgery had different outcomes. Did they develop more meniscal tears? Were they more likely to experience earlier onset osteoarthritis? Were their rates of total knee replacement higher? The study had an average follow-up time of 13.7 years.

Treating ACL Injuries – ACL Reconstruction Surgery Vs. Non-Surgical Treatments

Based on the study, researchers found that non-surgical ACL injury patients had more issues later on in life. These individuals had a significantly higher likelihood of developing a secondary meniscal tear. They were also more likely to be diagnosed with osteoarthritis and undergo total knee replacement surgery.

According to the research findings, patients treated with a delayed ACL reconstruction greater than one year after the injury, had a higher likelihood of developing a secondary meniscal tear. Compared to the patients treated with early ACL reconstruction, those with a delayed ACL reconstruction were also more likely to be diagnosed with osteoarthritis.

Researchers also looked at which risk factors played a role in articular cartilage damage, meniscal pathology, and the advancement of arthritis. And they found that patient age was a factor. (more…)

The Zika Virus: An Overview

Zika Virus OverviewLouisville orthopedic surgeon Dr. Stacie Grossfeld is very interested in learning more about the Zika virus. One important reason is that joint pain is one of the major symptoms of Zika. And in reading about Zika, Dr. Grossfeld created an informative PowerPoint presentation, the: Zika Virus Overview, to share so that others can also become informed about this important public health issue.

Follow along for an overview of the Zika virus, and for more detailed information, visit the Centers for Disease Control and Prevention (CDC) website.

Understanding Zika

Zika is a virus spread by the bite of an infected Aedea species mosquito or through sex from a person who has the virus. Zika typically causes mild symptoms characterized as a fever, rash, joint pain and red eyes. While these symptoms usually only last a couple of days to a week in time, you may not show any symptoms even if you are infected, or the symptoms may not be noticeable.

Yet for one segment of the population, Zika is very serious. Zika poses a huge risk to unborn fetuses. The Zika virus has been connected to a birth defect called microcephaly along with other severe brain defects. Find more detailed information about pregnancy outcomes and Zika from the CDC.

A Brief History of the Zika Virus

The Zika virus originated in Uganda in 1947 when it was initially detected in monkeys. Nigeria reported the first human case in 1954.

Since this time, the virus has spread to other locations around the world including: South America, Africa, South East Asia and the Pacific Islands.

In May 2015, Brazil became a new site for the rapidly spreading virus. In July 2016, U.S. health officials reported 14 cases of Zika in a neighborhood in Miami, Florida.

People around the world, and especially those traveling to infected areas, are at risk of the Zika virus. Unfortunately, there is no current vaccine or medication to treat Zika. However, there are several things you can do to protect yourself against the spread of the Zika virus.

5 Tips to Help Prevent the Zika Virus

If you are interested in learning about ways to prevent Zika, here are five helpful tips.

  1. Avoid traveling to areas affected by the Zika virus.
  2. Always practice safe sex.
  3. Use Environmental Protection Agency (EPA) – registered insect repellents.
  4. Use mosquito nets, screened-in windows and doors to keep mosquitoes outside the home.
  5. Empty, clean and scrub items that hold water, including things like tires, buckets, planters, toys, pools, bird baths, flowerpots and trash cans.

Zika and Pregnancy:

The Zika virus is transmitted through sex from a person who has Zika to sex partners. The only way to eliminate the risk of getting Zika from sex is abstaining. You can protect yourself from the Zika virus during sex by practicing safe sex through condoms, dental dams and birth control. Zika Virus and pregnant Women

Pregnant women can pass the Zika virus to a fetus during pregnancy or around the time of birth. This virus is known for causing severe birth defects like the case of microcephaly. This disease is characterized by a below-average head size and inhibits the brain from growing at a normal rate. Zika can cause fatality, disabilities and developmental delays in children. (more…)

Life After ACL Injury – Risk for Secondary Injury in Youth Athletes

“If You Have an ACL injury and Undergo Surgery, is There a Risk for Secondary Injury in Youth Athletes?”

Understandably, many youth athletes, parents and physicians are concerned with secondary injury, especially following common injuries like an ACL injury. Youth athletes that undergo surgery following an ACL surgery should receive the best outcome for their future. Many athletes fear recurring injuries due to a previous surgery or injury.

ACL Re-injury in Youth Athletes There was an excellent review published in the July, 2016, American Journal of Sports Medicine that was performed at the Cincinnati Children’s Hospital. Dr. Amelia Wiggins was the lead author.

The study was a systematic review of literature from PubMed from 1966 to July 2015. PubMed is the U.S. National Library of Medicine National Health Institutes of Health. This online resource comprises more than 26 million citations from various biomedical journals, books and articles.

The authors reviewed all of the articles and selected only specific articles that met criteria for secondary injury in young athletes. Researchers reviewed 19 articles and used this data to formulate the bases of their research project.

Research Findings Re: ACL Injury in Youth Athletes

The researchers found that the second total ACL re-injury rate was 15 percent. Of this 15 percent, 7 percent of these injuries occurred on the same side of the body. Eight percent were on the opposite side of the body as the previous injury. The secondary ACL injury rate for both the same leg and the opposite leg for patients younger than 25 years was 21 percent. The secondary ACL injury for athletes that returned to sport was 20 percent. Researchers combined these risk factors and athletes 25 years and younger that returned to sports have a secondary ACL injury rate of 23 percent.

Researchers concluded that the combined data indicated that nearly one in four young athletes that have undergone ACL treatment will face another ACL injury in their career, most likely early after returning to play. (more…)