Sleeping Tips for Post-Operative Pain

When sleeping is hard with pain after surgery, here are some tips from Stacie Grossfeld, orthopedic surgeon in louisville, KY

When faced with an issue on our phones, laptops, or other various technological devices, oftentimes we know that by turning it off and then on again will reset the device, and things will begin working normally again. A good night’s sleep can sometimes do the same for humans! You go to sleep with a stomachache, or maybe you have a headache, or sore throat, and you wake up feeling just fine – a nice 8 hours seems to fix it better than any medicine would.

Sleep is obviously not the cure-all for every condition, but it is a critical factor in the body’s natural healing process. Proper sleep allows the body to heal in plenty of different ways, but specifically, it:

  • Prompts your immune system to activate the release of a type of small proteins called ‘cytokines,’ which fight inflammation, infection, and trauma
  • Allows you heart to take a break by dropping blood pressure, slowing breath, and relaxing the muscles of the body, which reduces inflammation
  • Replenishes your body’s energy and balances the hormones that contribute to hunger and stress
  • Slows brain activity, which can lead to a more productive attitude and positive feelings

When we’re in physical pain, though, as the result of a surgery, injury, or operation, it can be difficult to find a good night’s sleep in the cards. Especially if your injury affects your normal sleeping position, you might have a hard time catching your Z’s.

Here’s a few tips for sleeping with post-op pain, as well as the best sleeping positions for 4 common operations that Dr. Stacie Grossfeld, Orthopaedic Surgeon and Sports Medicine Specialist, helps rehabilitate.

General Post-Op Pain Sleeping Tips:

  • Practice Your Sleep

If you know you’ll be having an operation in the near future that will affect a part of your body for an extended period of time, practice your sleeping! An abrupt change in position might contribute to restlessness and, when combined with new pain, can be unmanageable. If you start shifting your position and sleeping differently before the pain is introduced, you’ll have a better chance at getting more sleep.

  • Take Pain Medications Strategically Before Bed

Pain medications differ in many ways, from potency, contents, time it takes to be effective, and the time it stays effective. Talk to your doctor beforehand about the medications you’ll be prescribed and get the scoop on side effects and if there are stipulations to when you can take them, because you’ll want that relief to help lull your body to sleep. This can be an important tool in your pain-fighting toolbox, so get your information from the source!

  • Establish a Strong Internal Clock

Waking up and going to bed at the same time everyday isn’t always the most glamorous nor the most convenient, but it helps a lot in the long run. Not only with pain! Having a consistent schedule leads to more, higher-quality sleep year-round, and that has proven to help you:

  • Get sick less often
  • Stay at a healthy weight
  • Lower your risk for serious health problems, like diabetes and heart disease
  • Reduce stress and improve your mood
  • Think more clearly and do better in school/at work
  • Get along better with people
  • Make better decisions to avoid injuries

The Best Sleeping Position for…

1. Knee Surgery and Knee Arthroscopy

For the best healing results after knee surgery, sleep on your back with your leg propped up and straight. However, DO NOT place the propping pillows directly under the knee, as this bends the knee slightly – instead, place them under your calf or foot so that the knee remains completely straight while elevated.

Most doctors don’t recommend sleeping on your side until further along in your treatment and healing, but side sleeping may be more comfortable for some and, with the right support, completely fine, as well. On some procedures, it’s better to wait for side sleeping until your doctor gives the green light, but it’s always important to keep a couple of pillows between your legs to keep your knee up.

2. Shoulder Surgery and Rotator Cuff Surgery

For any shoulder surgeries, including rotator cuff surgery, sleeping with an incline is the most recommended position. Whether this is on a recliner, with a wedge, or with a simple pillow-pile, an incline prevents you from rolling to your healing shoulder. This is a risk that sleeping on your non-operative side or back presents, and that cuts off the proper blood flow and put tension and pressure on the injury, potentially re-injuring it or slowing the healing process down.

If you or someone you love has suffered an injury and have undergone surgery for it in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help with your recovery. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

Educación del paciente: Cirugía Labral /SLAP/Bankart

Descripción General de la Cirugía Labral / SLAP / Bankart
Especialistas Ortopédicos 502-212-2663
Stacie Grossfeld, M.D. / Bess Fley, PA-C

Una descripción general de las reparaciones de Labral, Bankart y SLAP.

La reparación del labrum, reparación SLAP, y la cirugía de reconstrucción de Bankart se realizan como un procedimiento ambulatorio.

A su llegada al centro quirúrgico, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería.

Anestesia

La siguiente persona que conocerá es el médico de anestesia. En este momento, el anestesiólogo discutirá el proceso y abordará cualquier pregunta o inquietud que tenga sobre la anestesia. El anestesiólogo colocará un bloqueo nervioso para adormecer el hombro y el brazo. El medicamento anestésico durará 18 horas. Esta es una excelente manera de reducir el dolor postoperatorio. Incluso después de que el bloqueo nervioso desaparece, su nivel de dolor se reduce debido al efecto antidolor del bloqueo nervioso.

Después de colocar el bloqueo nervioso, usted irá a la sala de operaciones donde se realiza la reparación del labrum, la reparación SLAP y la cirugía de reconstrucción de Bankart. Luego, el anestesiólogo administrará una anestesia general, por lo que estará completamente dormido para el procedimiento. Usted puede ser intubado o no. Hay múltiples factores que determinan el tipo de anestesia. Su anestesiólogo discutirá eso con usted en detalle. Debido a que es una anestesia general, no escuchará ni verá nada de lo que sucede en la sala de operaciones.

Procedimiento quirúrgico

El Dr. Grossfeld realizará la reparación del labrum, SLAP, y Bankart artroscópicamente. Este procedimiento dura entre 45-60 minutos. Tenga en cuenta que después de regresar a la sala de operaciones, toma alrededor de 40-50 minutos irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 2.5 horas, dependiendo de qué tan extenso sea el procedimiento quirúrgico y qué deba solucionarse.

El Dr. Grossfeld hará de tres a cuatro incisiones pequeñas, que tienen menos de un centímetro de largo alrededor de la articulación del hombro. Ella colocará una pequeña cámara de alta definición, aproximadamente del tamaño de un lápiz, en la articulación del hombro. Después de insertar la cámara, se completa la inspección de toda la articulación del hombro. Se ve cada compartimento del hombro. Ella identificará dónde se encuentra el desgarro del labrum, SLAP, y Bankart. La reparación del labral/SLAP/Bankart se realiza colocando dos o más anclajes de sutura.

Los anclajes de sutura están hechos de un material óseo de tipo sintético, por lo que los anclajes se incorporarán realmente a su propio hueso. Unidos a la cabeza del anclaje de sutura están los puntos que se utilizan para reparar el labrum desgarrado. Los anclajes de sutura se colocan en el hueso que luego “ancla la sutura” y las suturas se cosen alrededor del labrum desgarrado. Los nudos se atan tirando del labrum desgarrado hacia el hueso donde estaba unido antes de que ocurriera el desgarro.

Si hay espolones óseos, se eliminarán con una pequeña herramienta que es similar a una herramienta Dremel. Si se extirpan los espolones óseos, el procedimiento se denomina descompresión subacromial y/o escisión de la articulación AC.

Al final de la cirugía, el sitio de la incisión/sitios portales se cierran con una sutura de color azul llamada Prolene. Las suturas se retirarán cuando lo vean en el consultorio entre 10 y 14 días después de la cirugía. No deje que las suturas o el sitio de la incisión se mojen. Puede limpiar los sitios de incisión con peróxido. Usted recibió instrucciones postoperatorias detalladas el día de la cirugía que explicarán el cuidado postoperatorio de la herida.

Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD, que son un apósito esponjoso más grande, seguido de cinta quirúrgica. Su cabestrillo de hombro especializado se colocará en la sala de operaciones.

Recibirá un conjunto detallado de instrucciones sobre el cuidado de la herida al ser dado de alta del centro quirúrgico.

Noche de Cirugía

Es muy importante que te mantengas al tanto del dolor. El hielo es clave. Es muy importante usar hielo tanto como sea posible. El Dr. Grossfeld recomienda el uso continuo de hielo durante todo el día. La regla es que no puedes usar demasiado hielo. Ya sea una unidad Polar Care, una bolsa de hielo o una bolsa de guisantes o maíz congelados: úselo continuamente durante 6-7 días después de la cirugía.

Tenemos una unidad Polar Care que se puede comprar a través de nuestra oficina. Básicamente es una máquina de hielo motorizada que tiene una envoltura de neopreno que se coloca sobre el hombro operatorio. Es un refrigerador que está lleno de hielo y agua. Sugerimos congelar 8 botellas de agua llenas de agua. Coloque cuatro de las botellas congeladas en la máquina y luego vierta agua alrededor de las botellas congeladas. Cuando las botellas se descongelen, cámbielas por las otras cuatro botellas de agua congelada que están en su congelador.

La unidad Polar Care tiene una manguera que se conecta a una envoltura de neopreno que rodea el hombro y empujará el agua helada a través de la envoltura de neopreno durante un máximo de nueve horas. De hecho, le recomendamos que use hielo durante todo el día. Es la mejor fuente de control del dolor y ayuda a reducir la hinchazón.

Ella recomienda que configure su despertador y tome su medicamento para el dolor cada 4 a 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas o Meloxicam 15 mg cada 24 horas puede ayudar a controlar el dolor. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal.

Puede ser más cómodo dormir en posición semi vertical. Dormir en un sillón reclinable o usar muchas almohadas para apoyar el hombro será más cómodo. Algunas personas dormirán en un sillón reclinable hasta 4 semanas después de la reparación del labrum / reparación SLAP / y la cirugía de reconstrucción Bankart. Cuando está acostado en la cama, permite que su hombro ruede hacia atrás y tira de la reparación, lo que puede causar dolor.

Uso de cabestrillo

Usted se despertará en la sala de recuperación con el cabestrillo en su lugar. Puede quitarse el cabestrillo siempre y cuando coloque el brazo contra el abdomen. El Dr. Grossfeld recomienda que duerma en el cabestrillo porque evitará que su brazo se mueva durante la noche.

Apósito quirúrgico

Al final de la cirugía, el Dr. Grossfeld, se pondrá un vendaje. El apósito es un montón de almohadillas de gasa 4×4, una almohadilla abd y luego una cinta quirúrgica especial va encima del apósito.

Consulte sus órdenes postoperatorias que recibirá el día de la cirugía para conocer los detalles del cambio de vendaje.

Los apósitos para comprar antes del día de su cirugía son: de diez a 15: almohadillas de gasa 4×4, cinta médica de papel, tiritas a prueba de agua y peróxido.

Primera visita postoperatoria

Su primera visita postoperatoria será de 10 a 14 días después de la cirugía. Usted será visto en la oficina en ese momento y le quitarán las suturas. El Dr. Grossfeld o Bess Fley, PA-C revisarán sus fotos quirúrgicas y responderán cualquier pregunta. En esta visita lo más probable es que se ordene fisioterapia. Por lo general, la fisioterapia es solo una o dos veces por semana durante las primeras seis semanas. El TP variará de persona a persona según el tamaño del desgarro y la calidad de la reparación.

Fisioterapia

Se le darán ejercicios para hacer post operatorio. Hay un enlace en sus instrucciones / órdenes postoperatorias que recibirá el día de su reparación del labrum, reparación SLAP y cirugía de reconstrucción Bankart. El enlace le mostrará cómo hacer algunos ejercicios postoperatorios suaves. En la primera visita postoperatoria, también deberá comprar un juego de poleas (puede comprar en nuestra oficina por $ 20) para permitirle trabajar en ejercicios de rango de movimiento pasivo en casa.

PT se divide en dos o tres bloques de 6 semanas, dependiendo de qué tan extensa sea la reparación.

Las primeras 6 semanas asistirás una o dos veces por semana para trabajar en ejercicios suaves de ROM pasiva.

Las segundas seis semanas, la terapia implica un rango activo de movimiento del hombro con un fortalecimiento suave. Asistirá de 1 a 3 veces a la semana, dependiendo de su reparación y otros factores.

Las terceras seis semanas de fisioterapia implican aumentar el rango de movimiento y fortalecer aún más.

Esto es aproximadamente una recuperación de cuatro a cinco meses antes de que vuelva a sus actividades normales que involucran el hombro operado.

Conducción

La mayoría de las personas comenzarán a conducir una vez que hayan dejado de tomar todos los analgésicos. Una vez que se inicia la conducción, su cabestrillo debe quitarse mientras conduce. Se recomienda que coloque su mano en el lado quirúrgico en la parte inferior del volante y su mano no quirúrgica en la parte superior del volante para hacer la mayor parte del trabajo.

Regreso al trabajo

Si trabaja en un trabajo de tipo laboral, lo más probable es que no regrese a ese trabajo hasta que sea liberado al 100%. Si su empleador tiene opciones de trabajo ligero, lo más probable es que sea liberado entre dos y cuatro semanas de regreso al trabajo ligero. Por lo general, el trabajo ligero no requiere el uso del lado quirúrgico / el lado en el que se realiza la reparación de labros, la reparación de BOFETADAS y la cirugía de reconstrucción de Bankart, excepto para tareas simples como usar una computadora o contestar un teléfono. Tenga en cuenta que si todavía está tomando analgésicos, no puede conducir un vehículo.

Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre dos y cuatro semanas. El regreso al trabajo también dependía del nivel de dolor. Algunas personas tienen mucho dolor después de la reparación del labrum, la reparación de SLAP y la cirugía de reconstrucción de Bankart, algunas personas tienen muy poco. El dolor es muy personal, y le proporcionaremos medicamentos para el dolor para cubrir su dolor según sea necesario. Se administrarán analgésicos durante un período de tiempo apropiado.

FMLA y papeleo de discapacidad

Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

Patient Education: Labral/SLAP/Bankart Surgery

Labral/SLAP/Bankart Surgery Overview
Orthopaedic Specialists 502-212-2663
Stacie Grossfeld, M.D. / Bess Fley, PA-C

An overview of Labral, Bankart, and SLAP Repairs.

Labral repair, SLAP repair, and Bankart reconstruction surgery is performed as an outpatient procedure.
Upon arrival at the surgicenter you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team.

Anesthesia

The next person you will meet is the anesthesia doctor. At this time the anesthesiologist will discuss the process and address any questions or concerns you have about the anesthesia. The anesthesiologist will place a nerve block to numb up your shoulder and arm. The numbing medicine will last for 18 hours. This is a great way to reduce post operative pain. Even after the nerve block wears off, your pain level is reduced because of the anti-pain effect from the nerve block.

After the nerve block is placed, you will go to the operating room where the Labral repair, SLAP repair, and Bankart reconstruction surgery is performed. The anesthesiologist will then administer a general anesthesia, so you are completely asleep for the procedure. You may be intubated or not. There are multiple factors that determine type of anesthesia. Your anesthesiologist will discuss that with you in detail. Because it is a general anesthesia you will not hear or see anything going on in the operating room

Surgical Procedure

Dr. Grossfeld will then perform the labral / SLAP / Bankart repair arthroscopically. This procedure takes between 45-60 minutes. Keep in mind after you head back to the operating room it takes about 40-50 minutes to go to sleep and get positioned on the operating room bed, so your family may not see you for 2.5 hours depending on how extensive the surgical procedure is and what needs to be fixed.

Dr. Grossfeld will make three to four small incisions, which are less than a centimeter in length around the shoulder joint. She will place a small high-definition camera, about the size of a pencil, into the shoulder joint. After the camera is inserted, inspection of the whole shoulder joint is completed. Each compartment of the shoulder is viewed. She will identify where the labral / SLAP / Bankart tear is located. The repair of the labral / SLAP/ Bankart is done by placing two or more suture anchors.

The suture anchors are made out of a synthetic-type bone material, so the anchors will actually incorporate into your own bone. Attached to the head of the suture anchor are the stitches that are used to repair the torn labrum. The suture anchors are placed into the bone which then “anchors the suture” and the sutures are then sewn around the torn labrum. Knots are tied pulling the torn labrum back down to the bone where it was attached before the tear occurred.

If there are any bone spurs, they will be removed with a small tool that is similar to a Dremel tool. If bone spurs are removed, the procedure is called a subacromial decompression, and/or an AC joint excision.

At the end of the surgery the incision site/portal sites are closed with a blue colored suture called Prolene. The sutures will be removed when you are seen in the office at 10 to 14 days post-surgery. Do not let the sutures or the incision site get wet. You can clean the incision sites with peroxide. You received detailed post operative instructions the day of the surgery that will explain post operative wound care.

Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites followed by ABD pads, which are a larger fluffy dressing, followed by surgical tape. Your specialized shoulder sling will be placed on in the operating room.

You will get a detailed set of instructions on wound care upon discharge from the surgery center.

Night of Surgery

It is very important that you stay on top of the pain. Ice is key. It is very important to use ice as MUCH as possible. Dr. Grossfeld recommends continuous use of ice around the clock. The rule is you cannot use too much ice. Whether it is a Polar Care unit, ice pack or a bag of frozen peas or corn: use it continuously for 6-7 days after surgery.

We do have a Polar Care unit that can be purchased through our office. It is basically a motorized ice machine that has a neoprene wrap that gets placed over the operative shoulder. It is a cooler that is filled with ice and water. We suggest freezing 8 water bottles filled with water. Put four of the frozen bottles in the machine then pour water around the frozen bottles. When the bottles thaw out swap them out for the other four frozen water bottles that are in your freezer.

The Polar Care unit has a hose that connects to a neoprene wrap that goes around the shoulder, and will push ice water through the neoprene wrap for up to nine hours. We actually recommend you use ice around the clock. It is the best source of pain control and helps to reduce swelling.

She recommends that you set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours or Meloxicam 15 mg every 24 hours can help to control pain. Do not use either Motrin or Meloxicam if you are on blood thinners or have a history of stomach ulcers or kidney disease.

It may be more comfortable to sleep in a semi-upright position. Sleeping in a recliner or using lots of pillows to support your shoulder will be more comfortable. Some people will sleep in a recliner for up to 4 weeks after labral repair / SLAP repair / and Bankart reconstruction surgery. When lying flat in bed, it allows your shoulder to roll back and tugs on the repair, which can cause pain.

Sling Use

You will wake up in the recovery room with your sling in place. You may take the sling off as long as you place your arm against your belly. Dr. Grossfeld recommends that you sleep in the sling because it will prevent your arm from moving around during the night.

Surgical Dressing

At the end of the surgery, Dr. Grossfeld, will put on a dressing. The dressing is a bunch of 4×4 gauze pads, an abd pad and then a special surgical tape goes on top of the dressing. Please refer to your post operative orders that you will receive day of surgery for dressing change details.
Dressings to purchase before your surgery day are: ten to 15: 4×4 gauze pads, paper medical tape, water proof band aids and peroxide.

First Post-Operative Visit

Your first post operative visit will be 10-14 days post-surgery. You will be seen in the office at that time and have your sutures remove. Dr. Grossfeld or Bess Fley, PA-C will go over your surgical photos and answer any questions. At this visit most likely physical therapy will be ordered. Typically, physical therapy is only once or twice a week for the first six weeks. PT will vary from person to person based on the size of the tear and repair quality.

Physical Therapy

You will be given exercises to do post op. There is a link on your post operative instructions/orders that you will get the day of your labral repair, SLAP repair, and Bankart reconstruction surgery. The link will show you how to do some gentle post operative exercises. On the first post operative visit you will also need to purchase a set of pulleys (can purchase from our office for $20) to allow you to work on passive range of motion exercises at home.

PT is divided into two to three 6-week blocks depending on how extensive the repair.

The first 6 weeks you will attend once or twice a week to work on gentle passive ROM exercises.

The second six weeks, the therapy involves active range of motion of the shoulder with some gentle strengthening. You will attend 1-3 times a week, depending on your repair and other factors.
The third six weeks of physical therapy involves increasing range of motion and further strengthening.

This is about a four to five month recovery before you are back to your normal activities involving the operative shoulder.

Driving

Most people will start driving once they are off all pain medication. Once driving is started your sling needs to be taken off while driving. It is recommended that you place your hand on the operative side at the bottom of the steering wheel and your non-surgical hand at the top of the steering wheel to do most of the work.

Return to Work

If you work a labor type job, you will most likely not return back to that job until you are released 100%. If your employer has light duty options, you will most likely be released anywhere between two to four weeks back to light duty. Typically, light duty will not require the use of the surgical side/the side your labral repair, SLAP repair, and Bankart reconstruction surgery is performed on, except for simple tasks such as using a computer or answering a phone. Keep in mind if you are still taking pain medication you cannot drive a vehicle.

If you have an office type job, you can most likely get back to work between two to four weeks. Return to work also depended on pain level. Some people have a lot of pain after labral repair, SLAP repair, and Bankart reconstruction surgery, some people have very little. Pain is very personal, and we will supply you with pain medication to cover your pain as needed. Pain medication will be given for an appropriate amount of time.

FMLA and Disability Paperwork

Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

An Interview with Dr. Grossfeld: A (Late) Celebration of National Women Physician Day

We celebrate National Women Physician Day everyday with Dr. Stacie Grossfeld, double board certified sports medicine and orthopedic surgeon

On February 3rd, the nation came together to celebrate a group of professionals that deserve 100% of the glory: women physicians. National Women Physician Day gives due credit to women, who have worked long and hard to get to where they are today, and Orthopaedic Specialists, PLLC is quite a special place, as we get to celebrate women physicians everyday – we’re owned and operated by our very own female physician, Dr. Stacie Grossfeld, M.D.

We might be a little late to Women Physician Day, but we figured that International Women’s Day was just as fitting!

About Dr. Grossfeld, M.D.

Dr. Stacie L. Grossfeld started her journey to being the double bard-certified orthopaedic surgeon she is today as a graduate of the University of Louisville School of Medicine. She served her internship and residency at the University of Minnesota and then additionally completed a fellowship in Sports Medicine at the Fowler- Kennedy Sports Medicine Center. Now, Dr. Grossfeld is an independent, non-hospital employed orthopedic surgeon practicing in private practice at Orthopedic Specialists in Louisville, Kentucky and double board-certified in orthopedic surgery by the American Board of Orthopedic Surgeons and in sports medicine, also through the American Board of Orthopedic Surgeons.

To get Dr. Grossfeld’s extensive history, opportunities, awards, achievements, and work, visit her About page on the website! To celebrate her practice and work, we got a small interview to get her perspective on how it feels to be a woman in the medical field, along with a few get-to-know-you questions for her patients to enjoy!

An Interview with Dr. Grossfeld

  1. What interests you most about your area of work?

Dr. Grossfeld: “Every day is different. Every patient has different problems and needs and it’s extremely rewarding to help patients regain their mobility, independence, and return to their job or sporting activity!

  1. What is your favorite part of your work?

Dr. Grossfeld: “Truly helping people is my favorite part. When the patients come back in the office and I see that they are so happy to be out of pain, it’s the best feeling ever.”

  1. When going through medical school, what was the most challenging for you?

Dr. Grossfeld: “Medical School required a lot of information to be learned at a rapid pace. I made sure I studied really hard everyday so that I never had to cram for exams, because that would have been too stressful for me, personally. However, I really had to be super focused and put most of my life on hold during those years because the intensity of medical school, and I found that to be very challenging for who I am and my personality.”

  1. If you weren’t double board-certified in Orthopedic Surgery and Sports Medicine, what areas or other careers do you think you would be practicing in?

Dr. Grossfeld: “The fashion industry, for sure! I think I would fit right in working for the House of Gucci or the House of Chanel, personally.”

  1. In your opinion, what are the best opportunities your work has brought you?

Dr. Grossfeld: “Besides the day-to-day opportunity to work with my patients, the ability the teach other doctors and mentor other females in business and in medicine has been something I love doing and am extraordinarily grateful for.”

  1. What are your favorite things to do outside of work?

Dr. Grossfeld: “In my free time, I am avidly into sports! I love to play tennis, ride my bike, ski, and do various other stuff with my family.”

  1. What accomplishments have you achieved and which are you most proud of?

Dr. Grossfeld: “Personally, I’m most proud of being able to run my own practice, teach the U of L residents, and still continue to be able to maintain a home-life with my husband and son.”

We thought it might be pertinent to mention that there is a very long list of other accolades listed on her page, including:

  • The recipient of the National Association of Women Business Owner’s (NAWBO) Small Business Owner of the Year Award in 2016
  • The Most Compassionate Doctor Award
  • A place on the Top Ten Orthopedic Doctor list in Louisville, Kentucky
  • The Patient’s Choice Award as a top-rated doctor on vitals.com
  • The YMCA’s Volunteer of the Year award given to her by the Norton Commons YMCA
  • Orthopaedic Specialists PLLC has received the 2017 Business of the Year Award from Louisville Business First
  1. When (or if) you plan to retire, what will you miss most about your work?

Dr. Grossfeld: “Ha! Good question – my husband asks me what I am going to do when I retire and my answer is always ‘work’. I would miss the daily interaction with the patients, my staff, and the residents. But I don’t think I could stop working and contributing and learning! I’ve thought about perhaps opening up a glass blowing studio or starting a community garden when the time comes.”

  1. Have you ever found it difficult to be a female physician?

Dr. Grossfeld: “I have not, but I know that many women in ortho have, as closely-tied to sports as it is, and they are infinitely deserving of National Women Physician Day. We all know how it is when it comes to most men and sports – they want to be as close to the action as possible, and that means that it can be very competitive and male-dominated in some areas (most areas, actually, since only about 11% of practicing orthopedic surgeons in the US were women in 2022). Fortunately, I was in a residency that had a lot of female residents, and I have received countless compliments from patients that state they feel female doctors listen better and are more compassionate compared to male doctors, so I would strongly advise not letting the gender disparity stop women from entering the field of ortho medicine!”

  1. Is there any advice you would give to other women going into the medical field?

Dr. Grossfeld: “Do what you love; this is a career, not a job, and we cannot do it all. You’ll need help if you are going to have a family – either a husband that works from home or close relatives that can help raise your kids. It truly takes a village in this line of work!”

National Women Physician Day acknowledges the roadblocks and barriers that have been presented to women throughout history, and honors how they paved the way for today’s generation of women. Although there is still struggle and gender disparity, we’re slowly closing it. To learn more about the history behind National Women Physician Day, visit the University of Madison-Wisconsin’s blog!

If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, double board-certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments can be available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

A Study on Concussions: Treatment Methods and Rehabilitation

What are the best methods of recovery from a concussion?

 

 

 

 

 

 

 

 

As the last installment in this series on concussions, we’ve touched on the symptoms and dangers of concussions as well as put the spotlight on our special guests, Harriet Owen and the Lynn Family Vision Training Center. When it comes to treatment methods and rehabilitation, both of our spotlight partners give great advice and examples of healthy ways to recondition your brain after a head injury.

Why Would You Need Reconditioning After a Concussion?

The brain accounts for 20% of the body’s energy use and plays a massive part in controlling bodily functions as a big part of the central nervous system, such as thought, memory, emotion, touch, motor skills, vision, breathing, temperature, hunger, perception, and practically every other process that you associate with the body. That’s pretty important, right? So, if you would go to the doctor after you hurt your foot because you don’t like the pain and inconvenience it presents in your daily activities that you need that foot for, why wouldn’t you go after a brain injury when every activity needs the brain?

While they are quite elastic, there is only so much that a brain can recover from on its own. With the help of rehabilitation habits and other emerging treatments, you can come back even stronger. But if neglected, brain functions can deteriorate over the course of a concussion. As Dr. Mark Lynn says, “The brain is injured until it is fixed.” And it can’t always do that on its own. In fact, people have been known to experience symptoms and effects of concussions long after doctors or trainers give them the green light to return to daily life when no rehabilitation was pursued; this is called post-concussion syndrome, and it can last for months or even years.

But the name ‘post-concussion syndrome’ is misleading because sometimes, it’s not ‘post-concussion’; it’s an active concussion at work that will continue to affect brain functions until addressed.

Harriet Owen began spiraling with what other doctors would label ‘post-concussion syndrome.’ Once she received the correct diagnosis, she found results when she partnered up with Lynn Family Vision and Dr. Tad Seifert, who were able to guide her out of the habits she had formed early in the concussion.

With so much variation in the advice for treatment and recovery from concussions, what are the “do’s and don’ts” that come from the experts and the experienced?

Do’s and Don’ts of Concussion Recovery

From Lynn Family Vision

With as much cutting-edge technology and innovative treatment methods that Lynn Family Vision has available, along with the years of experience researching and working directly with both vision and neuro-optometric patients, there’s a lot of advice to be taken from the Lynns.

The very first piece of advice they would give is to be very wary of traditional treatment methods. Loved ones with your best interests at heart or outdated internet articles might tell you that a dark room to rest your brain is the best way to go, but that is the worst advice to follow!

Dr. Mark Lynn maintains, along with several other leading researchers in the area (like the University of Michigan), that near immediate cognitive exercise can decrease the time needed for recovery. Not to any extremes, as overworking a concussed brain can worsen a concussion, but something as simple as bouncing a ball at night and trying to focus on precision and accuracy is one of his go-to recovery methods that almost everyone can do.

However, other traditional recovery methods are ones that Dr. Lynn can get behind, such as:

  • Limiting or avoiding screen-time
  • A gradual re-introduction to normal activities
  • Lots of rest
  • Being patient with yourself while you work back up to where you were, because your brain will not be at 100% as soon as a doctor or trainer gives you the green light

Lynn Family Vision is fortunate enough to have available innovative new technology that trains the brain through how it perceives the world through the eyes. As neuro-optometric specialists, they are constantly exposed to the effects of concussions and, subsequently, how to right them. Contact Lynn Family Vision today to book an evaluation and create plan of action to re-train your brain for healthier functions.

From Harriet Owen 

As Harriet’s situation developed from a lack of proper treatment from the correct doctors, her advice is to not wait to seek out advice from specialists. As soon as you realize that your symptoms are growing or are not going away, the correct help can make all the difference in your recovery journey.

Even if the injury is one you’ve seen or had many times before, there is always a chance that something went differently this time. Women in particular can get concussions easier and on a more severe scale than men, and once someone has gotten a concussion, it will be easier to get an even worse one in the future. Brushing symptoms off because of the perception that ‘you know how to deal with it’ or ‘you don’t think it’s that serious’ or ‘it’s happened before’ has a high potential of making everything worse for much longer and requiring more work to get back to where you were before the injury.

Don’t Wait!

If you or someone you love has suffered a concussion or an injury as a result of a concussion in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

Educación del paciente: Cirugía de desgarro de menisco/endoscopio de rodilla/artroscopia

Cirugía de Desgarro de Menisco / Endoscopio de Rodilla / Artroscopia de Rodilla Descripción General
Especialistas Ortopédicos 502-212-2663
Stacie Grossfeld, M.D. / Bess Fley, PA-C

Llegada al Centro Quirúrgico

  1. Usted será registrado en el centro de cirugía.
  2. Se revisarán sus signos vitales, como la presión arterial y la temperatura.
  3. Se proporcionará una bata de hospital limpia.
  4. Todas las joyas, dentaduras postizas, lentes de contacto y esmalte de uñas deben ser quitados o un esmalte de color muy claro.
  5. Se iniciará una vía intravenosa para administrarle líquidos y medicamentos durante y después del procedimiento.
  6. Su rodilla será frotada y afeitada en preparación para la cirugía.
  7. Un proveedor de anestesia discutirá el tipo de anestesia que se utilizará.
  8. Su cirujano confirmará e inicializará el sitio quirúrgico correcto.

Procedimiento quirúrgico

La cirugía de desgarro de menisco (artroscopia de rodilla) es un procedimiento ambulatorio que se realiza en un centro quirúrgico. La cirugía en sí le toma al Dr. Grossfeld aproximadamente 20 minutos en completarse. Sin embargo, se necesita tiempo para regresar a la sala de operaciones, se debe administrar anestesia y debe colocarse en la mesa de la sala de operaciones. Eso agregará tiempo total al procedimiento. Después de que el Dr. Grossfeld esté completo con el procedimiento quirúrgico, se necesita tiempo para despertar de la anestesia y ser transportado de regreso a la sala de recuperación. Cuando se agregan todos los diferentes componentes en el procedimiento es de aproximadamente una a 1.5 horas.

La artroscopia de rodilla se realiza con anestesia general. Usted estará completamente dormido para la cirugía, por lo tanto, no escuchará ni verá nada durante el procedimiento.

El Dr. Grossfeld hará tres pequeñas incisiones alrededor de la articulación de la rodilla. Las incisiones son de aproximadamente media pulgada de largo.

Una visión general de la cirugía de desgarro de menisco del Dr. Grossfeld.

Luego insertará una cámara de alta definición en la articulación de la rodilla, que es aproximadamente del tamaño de un lápiz. La parte interna de la articulación de la rodilla se proyecta en un gran monitor de video 4K.

El Dr. Grossfeld inspeccionará toda la articulación de la rodilla. Ella pasará por los tres compartimentos de la rodilla. Durante este tiempo evaluará cualquier daño y / o patología que necesite ser reparada quirúrgicamente. El Dr. Grossfeld también documentará los hallazgos anormales, si los hay. Se toman fotos en color durante todo el procedimiento.

Mientras realiza la artroscopia de rodilla, el Dr. Grossfeld, identificará el (los) desgarro (s) de menisco (s) y / o cualquier otra patología. Ella quitará la parte del menisco que está rasgada con un par de tijeras microscópicas y pulirá los bordes. Si el menisco es un desgarro de tipo reparable (muy raro <2% de los desgarros de menisco son reparables), entonces se colocará una serie de suturas (puntos) en el menisco para repararlo.

Cuando se extirpa la parte desgarrada de los meniscos, las porciones restantes del menisco, que están sanas, permanecen en la articulación de la rodilla. El menisco restante funcionará como un amortiguador para la articulación de la rodilla.

Cuando el menisco se rompe, es muy doloroso, y al eliminar la porción desgarrada del menisco, el dolor desaparece.

Al final del procedimiento quirúrgico, el Dr. Grossfeld inyectará un medicamento anestésico en los sitios de incisión, por lo que generalmente hay muy poco dolor inmediatamente después de la cirugía. La mayoría de las personas usarán menos de tres analgésicos, y muchas veces su dolor se controla solo con ibuprofeno y / o hielo junto con Tylenol.

Una visión general de la cirugía de desgarro de menisco del Dr. Grossfeld.

Las imágenes de arriba: las flechas rojas revelan el menisco desgarrado. Las flechas azules muestran un menisco normal. La imagen de la izquierda es un desgarro meniscal con mango de cubo y la imagen de la derecha: un desgarro meniscal de tipo radial

No se colocarán suturas en los sitios de incisión. El Dr. Grossfeld usará pequeñas curitas blancas llamadas Steri-Strips para cerrar los sitios del portal. Por lo tanto, no hay suturas que deban retirarse después de la operación. Es completamente normal sangrar a través de los apósitos y que las tiras estériles tengan sangre seca una vez que se retira el apósito. Por favor, deje las tiras de ste ri-strips hasta su primera visita postoperatoria. Están cerrando las incisiones quirúrgicas y el sitio de la incisión necesitará alrededor de 7-9 días para sanar. Si las tiras estériles se caen por sí solas, está bien.

Apósito quirúrgico

Al final de la cirugía, el Dr. Grossfeld, se pondrá un vendaje. El apósito es un montón de almohadillas de gasa 4×4, una almohadilla abd, seguida de relleno fundido (material blanco elástico). Luego se coloca una envoltura Ace alrededor de la rodilla en la parte superior de los apósitos mencionados anteriormente. La envoltura ace se puede suspender cuando la hinchazón en la articulación de la rodilla es mínima. La envoltura as ayuda a reducir la hinchazón. El Dr. Grossfeld recomienda usar el as si hay hinchazón presente. Consulte sus órdenes postoperatorias que recibirá el día de la cirugía para conocer los detalles del cambio de vendaje.
Los aderezos para comprar antes del día de la cirugía son: diez almohadillas de gasa 4×4, una envoltura extra de 6 pulgadas y peróxido.

Sala de recuperación

Después de la cirugía, usted será transportado a la sala de recuperación para una observación minuciosa de sus signos vitales y circulación. Usted puede permanecer en la sala de recuperación durante una o dos horas, dependiendo de qué tan rápido se recupere de la anestesia.

Muletas

Las muletas pueden o no ser usadas o necesarias. Las muletas serán suministradas por la mayoríade los centros de cirugía. Amazon también vende diferentes tipos de muletas. La mayoría de las personas están fuera de las muletas dentro de 2-4 días. Los pacientesni siquiera usan muletas, pero eso depende del paciente.

Cuidado postoperatorio de la rodilla: hielo / ducha

Sele proporcionará un conjunto detallado de instrucciones sobre cómo cuidar su rodilla después de la cirugía.

Es muy importante usar hielo tanto como sea posible. El Dr. Grossfeld ordena el uso continuo de hielo durante todo el día. La regla es que no puedes usar demasiado hielo. Berg Polar Care Unit se puede comprar en nuestra oficina.

Recomendamos usarlo continuamente durante 3-4 días después de la cirugía. Le recomendamos que duerma con la Unidad de Cuidados Polares de Berg alrededor de la articulación de la rodilla para que se aplique hielo toda la noche. Es la mejor fuente de control del dolor y ayuda a reducir la hinchazón.

La unidad Berg Polar Care está llena de hielo y agua. Tiene una manguera que se conecta a una envoltura de neopreno que rodea la rodilla y empujará el agua helada a través de la envoltura de neopreno durante un máximo de nueve horas. La unidad está motorizada y se conecta a una toma de corriente. De hecho, le recomendamos que use ice durante todo el día. Le recomendamos que duerma con hielo alrededor de la rodilla. Es la mejor fuente de control del dolor y ayuda a reducir la hinchazón. La Unidad de Cuidados Polares de Berg se puede comprar en la oficina del Dr. Grossfeld. Pregúntale a cualquiera de los asistentes.

El primer par de días después de la cirugía planee limitar su actividad y mantener su pierna elevada por encima de su corazón para reducir la hinchazón. Trabaje en mover el pie hacia arriba y hacia abajo para prevenir coágulos de sangre en la parte inferior de la pierna.

Es normal tener hinchazón en el tobillo, el pie y los dedos de los pies después de la cirugía. Lo que no es normal es si hay dolor en el área de la pantorrilla de la parte inferior de la pierna. Eso puede ser un signo de un coágulo de sangre. Si eso ocurre, se necesita una visita al departamento de emergencias de inmediato.

Se le darán instrucciones detalladas sobre cómo hacer los cambios de vendaje después de la cirugía. Las órdenes postoperatorias se le darán el día de la cirugía. Asegúrese de leerlos.

Mantenga la rodilla seca. Puede ducharse, pero coloque una envoltura a prueba de agua alrededor de la rodilla, como una bolsa de basura o una envoltura de Saran. Puede ducharse de inmediato siempre y cuando la rodilla permanezca seca.

Noche de Cirugía

La anestesia recomendará que un familiar o amigo se quede con usted durante la noche durante la primera noche después de la cirugía. Yoce es tu mejor amigo. Tome sus medicamentos para el dolor o medicamentos antiinflamatorios antes de acostarse y a primera hora de la mañana siguiente.
Bombee sus pies y tobillos hacia arriba y hacia abajo para ayudar a prevenir la formación de sangre en las piernas. Una vez que comienzas a caminar; Bombear el pie y los tobillos se vuelve menos necesario.

Actividad postoperatoria

Se permite la carga de peso completa, para la mayoría de los pacientes. Sus instrucciones de postop detallarán el estado de soporte de peso. Subir escaleras está bien si te sientes cómodo y no sientes que perderás el equilibrio. Si su habitación está arriba y le preocupa la estabilidad, está bien subir las escaleras en su bo.

Comience a trabajar en ejercicios de rango de movimiento para la rodilla para ayudar a prevenir la rigidez excesiva y esto también ayudará a reducir la hinchazón.

La mayoría de las personas conducen en una semana.

Sigue

Usted hará un seguimiento postoperatorio en la oficina, aproximadamente 10-14 días después de la cirugía.

La fisioterapia se puede recomendar según el rango de movimiento y la función de la rodilla. La necesidad de fisioterapia se determina en esta cita. La mayoría de los pacientes no necesitan fisioterapia después de una artroscopia de rodilla.

Regreso al trabajo

La descripción del trabajo de cada persona y el nivel de dolor son únicos, por lo tanto, la capacidad de regreso al trabajo se realiza paciente por paciente.

Sin embargo, en general, si tiene una posición de tipo de trabajo de parto, entonces la capacidad de regreso al trabajo suele ser dentro de las 4-6 semanas posteriores a la cirugía. Si su empleo es un trabajo de tipo sentado, entonces la capacidad de regreso al trabajo puede ser antes de la primera semana postoperatoria o poco después de la primera cita postoperatoria. El regreso al trabajo es muy individualizado. El Dr. Grossfeld lo involucrará en la decisión de trabajar y qué restricciones pueden ser necesarias.

Finalmente, es importante tener en cuenta que si se encuentra artritis en la articulación de la rodilla en el momento del procedimiento quirúrgico, puede estallar por la cirugía. Si eso ocurre, puede ser necesario que se administre una inyección de cortisona un par de semanas después de la cirugía.

FMLA y papeleo de discapacidad

Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. A menudo, las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

Patient Education: Meniscal Tear Surgery/Knee Scope/Knee Arthroscopy

Meniscal Tear Surgery/Knee Scope/Knee Arthroscopy Overview
Orthopaedic Specialists 502-212-2663
Stacie Grossfeld, M.D. / Bess Fley, PA-C

Arrival to the Surgicenter Center

  1. You will be checked into the surgery center.
  2. Your vital signs, such as blood pressure and temperature, will be checked.
  3. A clean hospital gown will be provided.
  4. All jewelry, dentures, contact lenses, and nail polish must be removed or a very light color polish.
  5. An IV will be started to give you fluids and medication during and after the procedure.
  6. Your knee will be scrubbed and shaved in preparation for surgery.
  7. An anesthesia provider will discuss the type of anesthesia that will be used.
  8. Your surgeon will confirm and initial the correct surgical site.

Surgical Procedure

Meniscal Tear Surgery (Knee arthroscopy) is an outpatient procedure performed in a surgery center. The surgery itself takes Dr. Grossfeld approximately 20 minutes to complete. However, there is time needed to head back to the operating room, anesthesia needs to be administrated and positioning on the operating room table must occur. That will add total time to the meniscal repair procedure. After Dr. Grossfeld is complete with the surgical procedure there is time needed to wake up from the anesthesia and be transported back to the recovery room. When all the different components are added in the procedure is about one to 1.5 hours.

The knee arthroscopy is performed with a general anesthesia. You will be completely asleep for the surgery therefore you will not hear or see anything during the procedure.

Dr. Grossfeld will make three tiny incisions around the knee joint. The incisions are about a half inch in length.

What happens before, during, and after meniscal tear surgery with Dr. Grossfeld.She will then insert a high-definition camera in the knee joint, which is about the size of a pencil. The internal part of the knee joint gets projected up onto a large 4K video monitor.

Dr. Grossfeld will inspect the whole knee joint. She will go through all three compartments of the knee. During this time she will assess for any damage and/or pathology that needs to be fixed surgically. Dr Grossfeld will also document abnormal findings if any. Color photos are taken throughout the procedure.

While performing the knee arthroscopy, Dr. Grossfeld, will identify the meniscal tear(s), and or any other pathology. She will remove the part of the meniscus that is torn with a pair of microscopic scissors and buff the edges. If the meniscus is a repairable-type tear (very rare <2% of meniscal tears are repairable), then a series of sutures (stitches) will be placed in the meniscus to repair it.

When the torn part of the menisci is removed, the remaining portions of the meniscus, that is healthy, remains in the knee joint. The remaining meniscus will function as a shock absorber for the knee joint.

When the meniscus is torn, it is very painful, and by removing the torn portion of the meniscus, the pain goes away.

At the end of the surgical procedure, Dr. Grossfeld will inject numbing medicine into the incision sites so there is typically very little pain immediately post-surgery. Most people will use less than three pain pills, and many times your pain is controlled with just ibuprofen and/or ice along with Tylenol.

An overview of meniscal tear surgery from Dr. Grossfeld.

The images above: the red arrows reveal the torn meniscus. The blue arrows show a normal meniscus. The image to the left is a bucket handle meniscal tear and the image on the right: a radial type meniscal tear.

There will be no sutures placed in the incision sites. Dr. Grossfeld will use little white Band-Aids called Steri-Strips to close the portal sites. Therefore, there are no sutures that will need to be removed post operatively. It is completely normal to bleed through the dressings and for the steri-strips to have dried blood on them once the dressing is removed. Please leave the steri-strips on until your first post operative visit. They are closing the surgical incisions and the incision site will need about 7-9 days to heal. If the steri-strips fall off on their own that is okay.

Surgical Dressing

At the end of the surgery, Dr. Grossfeld, will put on a dressing. The dressing is a bunch of 4×4 gauze pads, an abd pad, followed by cast padding (stretchy white material). An Ace Wrap is then placed around the knee on top of the dressings listed above. The ace wrap can be discontinued when the swelling in the knee joint is minimal. The ace wrap helps to reduce swelling. Dr Grossfeld recommends wearing the ace if there is swelling present. Please refer to your post operative orders that you will receive day of your meniscal tear surgery for dressing change details.
Dressing to purchase before your surgery day are: ten 4×4 gauze pads, an extra 6-inch ace wrap, and peroxide.

Recovery Room

After surgery, you will be transported to the recovery room for close observation of your vital signs and circulation. You may remain in the recovery room for one to two hours depending on how quick you recover from the anesthesia.

Crutches

Crutches may or maybe not be used or needed. Crutches will be supplied by most surgery centers. Amazon also sells different types of crutches. Most people are off crutches within 2-4 days of the meniscal tear surgery. Some patients do not even use crutches but that is patient dependent.

Post Operative Care of the Knee: Ice/Showering

You will be provided with a detailed set of instructions on how to take care of your knee after meniscal tear surgery.

It is very important to use ice as MUCH as possible. Dr. Grossfeld orders continuous use of ice around the clock. The rule is you cannot use too much ice. Berg Polar Care Unit can be purchased from our office.

We recommend using it continuously for 3-4 days after surgery. We recommend that you sleep with the Berg Polar Care Unit around the knee joint so ice is being applied all night. It is the best source of pain control and helps to reduce swelling.

The Berg Polar Care unit is filled with ice and water. It has a hose that connects to a neoprene wrap that goes around the knee, and will push ice water through the neoprene wrap for up to nine hours. The unit is motorized and plugs into an electrical socket. We actually recommend you use ice around the clock. We recommend that you sleep with ice around the knee. It is the best source of pain control and helps to reduce swelling. The Berg Polar Care Unit can be purchased from Dr. Grossfeld’s office. Ask any of the assistants.

The first couple of days after surgery plan on limiting your activity and keeping your leg elevated above your heart to reduce swelling. Work on moving your foot up and down to prevent blood clots in the lower leg.

It is normal to have swelling in the ankle, foot, and toes after surgery. What is not normal is if there is pain in the calf area of the lower leg. That can be a sign of a blood clot. If that occurs a visit to the emergency department is needed immediately.

You will be given detailed instructions on how to do the dressing changes after surgery. The post operative orders will be given to you the day of surgery. Make sure you read them.

Keep the knee dry. You can shower but put a water proof wrap around the knee such as a garbage bag or Saran Wrap. You may shower right away as long as the knee stays dry.

Night of Surgery

Anesthesia will recommend that you have a family member or friend stay with you over night for the first night after surgery. Ice is your best friend. Take your pain meds or anti-inflammatory medication before you go to bed and first thing the next morning.

Pump your feet and ankles up and down to help prevent blood clots from forming in the legs. Once you start walking; pumping the foot and ankles becomes less necessary.

Post-Surgery Activity

Full weight-bearing is allowed, for most patients. Your postop instructions will detail weight bearing status. Climbing stairs is okay if you feel comfortable and do not feel like you will lose your balance. If your bedroom is upstairs and you are worried about stability, it is okay to scoot up the stairs on your bottom.

Please start to work on range of motion exercises for the knee to help prevent excessive stiffness and this will also help to reduce swelling.

Most people are driving within a week.

Follow-Up

You will follow up postoperatively in the office, approximately 10-14 days after surgery.
Physical therapy may be recommended based on range of motion and function of your knee. The need for physical therapy is determined at this appointment. The majority of patients do not need physical therapy after a knee arthroscopy.

Return to Work

Each person’s job description, and pain level is unique, therefore, the return-to-work capability is made on a patient-by-patient basis.

However, in general, if you have a labor type position, then return-to-work capability is typically within 4-6 weeks after surgery. If your employment is a sit-down type job, then return-to-work capability can be either before the first week postoperative or just shortly after the first postoperative appointment. Return to work is very individualized. Dr. Grossfeld will involve you in the decision to work and what restrictions may be needed.

Finally, it is important to keep in mind, if arthritis is found in the knee joint at the time of the surgical procedure, it may get flared up from the surgery. If that occurs it may necessitate that a cortisone injection be given a couple weeks post-surgery.

FMLA and Disability Paperwork

Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

February is All About Heart

What are the best exercises for heart health? Cardiovascular health in Louisville, KY.

The month of February seems to be overflowing with symbols of love and devotion: shaped into candy, stamped onto cards, sewn into pillows and stuffed animals – the heart is everywhere! Valentine’s Day is only one event that happens to fall in the short month, though; February is American Heart Month, too. So, while you shower your friends, partner, and family with affection, turn your gaze inward and show some love to your heart, as well!

It’s well known that exercise is the best way to keep a heart healthy, but did you know that there are certain one that are better for the cardiovascular system than others? It’s important to note that exercise and how safely you can do it changes with health conditions. If you have an existing heart condition or are at high risk of developing one, talk to your doctor about safe exercises and avoid strenuous workouts when you do!

Here’s a few of the best exercises for healthier hearts.

Heart-Healthy Exercises

1. Paced Walking

As an easy starting point as well as a very effective workout at any stage of fitness, walking is severely underrated. Not only is it easier on the body and joints than running and other exercises are, but it provides plenty of opportunity for an increased heart-rate while you chat with a friend, listen to an audiobook, or enjoy nature.

2. Cycling

Since you can control the resistance on a bike, cycling presents a very versatile workout that can be as easy or as difficult as you choose. It’s a great exercise for cardiovascular health, as the use of the bigger muscles in your legs really get the blood pumping and reduces the risk of heart disease.

3. Weight and Strength Training

Building muscles helps in several areas of cardiovascular health. Besides raising your heart-rate when you lift – or do body-weight exercises – strength training also increases the learn muscle mass that burns calories even when you’re at rest. This helps control and maintain weight, which is a big contributor to a healthy cardiovascular system.

4. Yoga

As a strength and flexibility exercise, yoga benefits the heart in more indirect ways than other exercises. Instead of raising your pulse, the mindfulness and calming facet of yoga can actually lower blood pressure and contribute to healthy cholesterol and blood glucose levels, which are good when it comes to heart health!

5. High Intensity Interval Training (HIIT)

With the constant fluctuation between intense activity and a recovery period, HIIT workouts strengthen the function of the heart and blood vessels by forcing a continuous raise and lowering of heart-rate and vessel contraction, which can be healthier than an uninterrupted moderate exercise!

6. Swimming

Easy on the joints, but a full-body workout: swimming has it all! Since you’re using almost every muscle to propel yourself through the water, the heart gets a workout trying to supply all the blood every muscle needs. Swimming decreases the risk of a myriad of different diseases and conditions, including heart disease and strokes.

Use your heart and show it some love this year, you’ll thank yourself later!

If you or someone you love has suffered an exercise injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

A Vision for the Future: Lynn Family Vision Training

Louisville, KY Sports training and vision training. Better reflexes, better vision, faster and quicker decision making

If you’re an avid soccer fan here in Louisville, perhaps the name ‘Lynn Family’ rings a bell; it is, after all, the name of the stadium that’s home to Racing Louisville FC and Louisville City FC. With naming rights having been purchased with a donation to its construction, the Lynn family name is known far and wide amongst the sports community, but you may be surprised to hear that having their name in the stadium lights isn’t the only reason that it resonates through athletes and others alike – it’s actually because of their vision training program.

Dr. Mark E. Lynn, his wife, Cindy Lynn, and their son, Dr. Mark J. Lynn, all play integral parts in running Louisville’s own Lynn Family Vision – a vision training facility that helps people at all stages of life in all sorts of situations.

Neuro-optometric rehabilitation in Louisville, KYDr. Mark J Lynn of Lynn Family Vision, Vision Training in Louisville, KYCindy Lynn business administration vision training

 

 

 

 

 

 

Now, you might be asking, “What is vision training? And why would people need it?” and the answer is deeper and more nuanced than you might expect. Follow along to find out what vision training is and just how applicable it has the potential to be for everyone.

What is Vision Training?

What the Lynn’s focus on over at Lynn Family Vision is a facet of the vestibular-ocular connection, or how the brain and the eyes interact and collaborate to signal to the body how to move and react to what you see happening around you. As you can imagine, if there is a discrepancy between those two critical organs and how they are able to function together, it greatly inhibits a person’s ability to live in the world that is actively happening, constantly moving, and always requiring the brain to process what the eyes see as they see it.

Depending on how drastic the discrepancy is, sometimes it’s not noticeable, but other times, it’s debilitating. That’s where Lynn Family Vision comes in – they’re the experts at what’s called neuro-optometric therapy and rehabilitation, or Vision Training.

This training is done using various tests to determine 6 different factors that are used to measure vestibular-ocular heath. These factors are:

1. Convergence (Fixation Stability): The ability to focus on a certain object or location

2. Divergence (Sciatic Eye Movement): The ability to move your eyes between two objects or locations

3. Visual Decision Making: The ability to process things visually at an acceptable speed

4. Choice Reaction Time: The ability to make a decision

5. Recognition: The ability to discriminate and identify objects where they are in space

6. Visual Acuity: The ability to process the speed of moving objects or stationary objects while in motion

Other than these factors aimed specifically towards neuro-optometric rehabilitation, Lynn Family Vision also provides training for:

    • Get customized vision training and neuro-optometric rehabilitation in Louisville, KYEye, Hand, Foot, and Head Coordination
    • Peripheral Vision
    • Tracking
    • Balance
    • Depth Perception
    • Contrast Sensitivity

If you’ve played sports, perhaps you’ve heard of IMPACT testing for concussions — a baseline test that measures cognitive function before a concussion so that they have measurements of comparison for after a concussion. That test measures in terms of memory, attention span, and visual and verbal problem solving in no specific terms – it’s merely to give doctors an objective baseline.

The testing at Lynn Family Vision brings those measurements into a narrower scope of quantifiable units, discerning results down to the millimeter as their technology tracks the movements and focus of the eye. This precise and comparable data is what lends the vision testing and training at Lynn Family Vision to so many applications, from athletes wanting to improve their performance to head trauma victims trying to get their life back.

Vision Training Applications

The patients at Lynn Family Vision come from all over with all sorts of conditions or situations. One of the greatest characteristics of vision training that makes it so potentially beneficial is its versatility and customizable nature. Insofar, Dr. Lynn and Dr. Lynn have been able to connect with patients across the globe and cross paths with other leading minds in the trade, such as Dr. William V. Padula of the Padula Institute of Vision Rehabilitation.

But let’s take a look at the types of cases that the Lynn family helps to rehabilitate on a regular basis.

Athletic Performance

Dr. Mark Lynn says that a majority of their regular patients at the moment come from an athletic background, and that he and his son have seen everyone from young prodigies and high school overachievers to professional cyclists and soccer players that play their games in the Lynn Family Stadium. The trick to a better performance, especially in cases where athletes have already undergone specialized and targeted training to improve a problem area with no results, can lie in a vestibular-ocular discrepancy.

A few millimeters difference in how fast your eye can get to the bottom right side of your vision as opposed to any other area of your vision wouldn’t be noticeable in most non-athletes’ lives – but when you’re a baseball or tennis player, or a goalie, then those few millimeters make all the difference. These athletes tend to use every one of the 6 facets listed above in tandem for a peak performance, so if one or more of these areas is lacking, even by the tiniest bit, then the overall performance is afflicted.

With Vision Training, though, athletes are trained with state-of-the-art technology and methods, and they come out with better, more precise focus, a higher decision-making speed, and a heightened ability to process their surroundings as they go about their games and matches.

Concussions

A concussion is defined as the result of a blow to the head or violent shaking. And the brain is half of the vestibular-ocular connection, a very important half. If the brain can’t process what the eyes see because of injury, then there’s a very large discrepancy, and that’s where a lot of concussion symptoms originate from. Dr. Lynn has described Vision Training as “PT for the Brain.” Much like when any other part of the body is injured, the brain also needs some TLC to get back to where it was before a concussion.

With Vision Training’s narrowed scope of results and the developing methods, there have been leaps and bounds made to apply these treatments regularly at sporting events with sideline technology that would help with response time, pre-injury training to provide more specific baseline data, and a fast recovery time. All of these things are being studied, but even in the first steps of analyzing neuro-optometric patients, Dr. Lynn says that they’ve found a 400-600% faster recovery time and that patients who have repeat concussions while undergoing or having previously undergone Vision Training have less severe concussions the second time around.

This application to concussions is oftentimes seen as a way to get back to sports as quickly as possible, but Dr. Lynn says that he deliberately makes the individual criteria that his patients must pass at a 60/40 split – 60% of the testing and training is done to get normal life back on track, which can include being able to get back to work or school, improving concentration and focus abilities, increasing energy levels, and expanding mental capacity. Only after that daily function is complete does the training differ to incorporate sports-related criterion and demands.

Academics

Dr. Lynn says that he respects learning disabilities of all types, forms, and functioning levels, and seeing kids, teens, and other individuals with fixation or perception struggles manage and overcome some of those disabilities is one of the most rewarding aspects of Vision Training. With ADHD and ADD diagnoses on the rise, Dr. Lynn states that there is always a chance that a child or teen’s inability to concentrate or unwillingness to participate in academics could be due to a vestibular-ocular discrepancy.

Without the physical ability to fixate on an object, process what the eyes see, and use that information to make a decision, schoolwork and traditional teaching methods can get very discouraging for a lot of children and teens. By training specifically for any discrepancy that the diagnostic visit might pick up, that vestibular-ocular connection grows stronger and in the correct way – kind of like a retainer fixing the alignment of teeth, or a brace realigning the spine. The eyes, if they aren’t correctly seeing things, and the brain, if it isn’t correctly perceiving things, can play a big part in academic performance and ability.

Brain Health

Another area where Dr. Lynn has begun to explore is the realm of brain health in a non-traumatic way. That is, conditions of the brain that didn’t come about because of injury. We as a society have been trying to manage onsets of dementia, Alzheimer’s, Parkinson’s, and strokes, amongst other conditions of the brain, and it’s long been known that one of the best defenses to these diseases and conditions is to maintain a healthy lifestyle and regularly give your brain a workout.

Vision Training is the workout that many like to give their brain. By exercising that vestibular-ocular connection, you’re using all the parts of your brain that you can. This benefits individuals who have family histories with brain diseases and conditions, those who have been diagnosed with early onset symptoms, or even those currently suffering from a condition. By retraining the brain, the consequences of a condition can be substantially combatted, especially conditions like Parkinson’s disease that affects movement.

Physical Health

The effects of Parkinson’s disease is a great segue into how Vision Training can benefit physical health, as well. Besides helping people after they’re injured to get back to a state of living where they’ll be able to do all the things they love and that they need to do to stay healthy, Lynn Family Vision has also seen patients that have described themselves as “perpetually clumsy.”

But if the movement that your brain signals for isn’t right because of a discrepancy in that brain-eye connection, it’s not clumsiness that causes falls, bumps, and collisions, it’s a misalignment of the eye. This is why Dr. Lynn has seen patients sent to them from nursing homes and assisted living centers – by training to be better at locating where objects are in space, like the ground, there is less of a risk of falling and hurting yourself.

The ability to make decisions and react also applies to our everyday life, because our ability to react to what’s happening determines our safety and stability. In a busy city, a car, a grocery store, and with as many distractions as we have, that reaction time is crucial to physical health and safety.

Career Performance

As a combination of performance, brain health, and overall benefit, Dr. Lynn says that they get a myriad of professionals looking to stay at peak performance when their career doesn’t lie in the sports field. And that isn’t all surprising when all of the factors tested and trained at Lynn Family Vision are important to everyday life and careers that require the same functions as sports do. That’s why they’ve seen and trained everyone from professional gamers to CEO and CFOs to keep a sharp game.

Think Vision Training May Be For You?

Vision rehabilitation in Louisville, KYMaintaining the ability to make decisions quickly and accurately based on what you see is a large part of the life of workers in any career and individuals at any stage of life, and that’s why Lynn Family Vision has been exploring avenues and partnerships to get more studies and data on the work that they’ve seen make a difference in real-time out there for the world to see.

Dr. Lynn says that it’s not just a sports endeavor for him – this neuro-optometric rehabilitation has the potential to change a lot of lives. In fact, one of the most common pieces of feedback that Dr. Lynn says he and his family hear is that Vision Training at Lynn Family Vision helped each of their patients to get their lives back.

If you’d like to explore what Lynn Family Vision does or schedule an appointment, visit their website, call them at +1 502-308-5966, or send them an email at info@lynnfamilysvt.com. Their office is located at 801 Edith Road Louisville, KY 40206, near Champions Park.

If you or someone you love has suffered a physical sports injury in the Louisville, Kentucky area, double-board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

Educación del paciente: Manipulación Cerrada Del Hombro

Una Visión General de la Manipulación Cerrada del Hombro
Especialistas Ortopédicos 502-212-2663
Stacie Grossfeld, M.D. / Bess Fley, PA-C

Una visión general de la manipulación cerrada del hombro de la cirujana ortopédica de Louisville, la Dra. Stacie Grossfeld.

Una manipulación cerrada del hombro es un procedimiento ambulatorio rápido. Se tarda unos 90 segundos en realizarse.

Anestesia

A su llegada al centro quirúrgico, se reunirá con el médico de anestesia y obtendrá un bloqueo nervioso. El bloqueo nervioso adormecerá el hombro durante aproximadamente 18 horas. Cuando se despierte del procedimiento, no tendrá ningún dolor. Para el procedimiento real, recibirá una anestesia muy breve.

Procedimiento

El Dr. Grossfeld moverá su brazo a través de un rango completo de movimiento que liberará las adherencias. Luego inyectará un poco de cortisona en la articulación del hombro mientras usted todavía está dormido. La cortisona ayuda con la inflamación posterior al procedimiento, la reducción del dolor y ayuda a prevenir adherencias recurrentes.

Se despertará, no tendrá dolor debido al bloqueo nervioso. La mayoría de los pacientes generalmente pueden comer una comida regular después del procedimiento. El bloqueo nervioso funcionará de 16 a 18 horas. Una vez que desaparece, el dolor suele ser mínimo.

Procedimiento posterior

Después de la manipulación, se dirige a su fisioterapeuta después del procedimiento. Mientras su brazo todavía está entumecido, el fisioterapeuta continuará trabajando para mover su brazo y estirar el hombro sin ningún dolor en absoluto. Por lo general, una vez que el bloqueo nervioso desaparece, el dolor en el hombro será mínimo.

Fisioterapia

Luego verá al fisioterapeuta cuatro veces la semana de la manipulación, cuatro veces la semana siguiente y luego dos o tres veces durante la tercera semana. Durante esas sesiones, su fisioterapeuta trabajará para mantener su rango completo de movimiento y trabajará para fortalecer los músculos del hombro.

Visita de seguimiento

El seguimiento con el Dr. Grossfeld es típicamente de 14 a 21 días después del procedimiento.

Regreso al trabajo

Si tiene un trabajo de escritorio / trabajo ligero, puede regresar al trabajo generalmente dentro de 4-5 días. Si tiene un trabajo de tipo laboral, podría ser de hasta 4 semanas porque una vez que se restaura el rango de movimiento, debe ocurrir el fortalecimiento.

FMLA y papeleo de discapacidad

Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. A menudo, las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.