What is a Torn Meniscus?

JoAnn Slosek, a registered nurse from Home & Community Health Services writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. My son has a torn meniscus. Last week my son-in-law was diagnosed with the same. Now my sister has injured her meniscus! What is going on here? What is a meniscus and why is it so easily injured?

A. A torn meniscus is one of the most common knee injuries. Any activity that causes one to forcefully twist or rotate the knee, especially when putting the pressure of full weight on it, can lead to a torn meniscus.

Two C-shaped pieces of cartilage known as the menisci (plural of meniscus) lie between the shinbone and the thighbone to stabilize and cushion the knee joint. Any activity (including kneeling, deep squatting or lifting something heavy) causing one to twist the knee, especially with forceful pressure, can lead to a torn meniscus.

Symptoms may include:

• A popping sensation
• Swelling or stiffness
• Pain, especially when twisting or rotating the knee
• Difficulty straightening the knee fully or experiencing what feels like a block to movement of the knee, as if it were locked in place

A torn meniscus can lead to knee instability, the inability to move the knee normally, or persistent knee pain. You also may be more likely to develop osteoarthritis in the injured knee.

A torn meniscus can often times be identified during a physical exam. The doctor may manipulate the knee and leg bones into different positions to help pinpoint the cause of the signs and symptoms.

Treatment for a torn meniscus often begins conservatively. The doctor may recommend:

• Rest.

Avoid activities that aggravate the knee pain, especially any activity that may cause one to twist the knee. Crutches may be useful to take pressure off the knee and promote healing.

 

• Ice.

Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time. Do this every four to six hours the first day or two, and then as often as needed.

 

• Medication.

Over-the-counter pain relievers also can help ease knee pain.

Conservative treatment is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.

Physical therapy can help strengthen the muscles around the knee and in the legs to help stabilize and support the knee joint. Arch supports or other shoe inserts can help to distribute force more evenly around the knee or decrease stress on certain areas of the knee.

If knee pain persists, or the knee is stiff or locked, the doctor may recommend surgery. It’s sometimes possible to repair a torn meniscus. In other cases, the meniscus is trimmed. Surgery may be done through an arthroscope.

During arthroscopic surgery, the doctor inserts an instrument called an arthroscope through a tiny incision near the knee. The arthroscope contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. Surgical instruments can be inserted through the arthroscope or through additional small incisions in the knee.

Recovery time following arthroscopic surgery tends to be much faster than it is for open-knee procedures. Many times it is day surgery. Full recovery, however, may take weeks or months and exercises are required to optimize knee strength and stability.

Avoid activities that aggravate the knee — especially sports that involve pivoting or twisting the knee — until the pain disappears. Ice and over-the-counter pain relievers can also help.

Exercises to strengthen the leg muscles can help stabilize and protect the knee joints. Start slowly, and increase the intensity gradually. Use protective gear when participating in recreational sports.

 

 

　

Gearing up for Flu Season and Washing Your Hands

JoAnn Slosek, a registered nurse from Home & Community Health Services, writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. I was asked this week if it was too early to the get the flu shot. Signs are appearing at drug stores and local health agencies are gearing up for flu clinics.

A. The Centers for Disease Control and Prevention (CDC) recommends that influenza vaccination begin as soon as the vaccine becomes available in the community and to continue throughout the flu season. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza; influenza seasons can begin as early as October. The CDC recommends that vaccination begin as soon as vaccine becomes available to ensure that as many people as possible are protected before flu season begins.

ONE OF THE BEST WAYS TO PREVENT THE SPREAD OF INFLUENZA IS TO WASH YOUR HANDS!

Hand washing is easy to do and it’s one of the most effective ways to prevent the spread of many types of infection and illness in all settings—from your home and workplace to child care facilities and hospitals. Clean hands can stop germs from spreading one person to another and throughout an entire community.

When should you wash your hands?

• Before, during and after preparing food
• Before eating food
• Before and after caring for someone who is sick
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning a child who has used the toilet
• After blowing your nose, coughing or sneezing
• After touching an animal, animal feed or animal waste
• After touching garbage

What is the correct way to wash your hands?

• Wet your hands with clean running water (warm or cold) and apply soap.
• Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers and under your nails.
• Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the “Alphabet Song” song from beginning to end.
• Rinse your hands well under running water.
• Dry your hands using a clean towel or air dry.

Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

 

Heart Disease

JoAnn Slosek, a registered nurse from Home & Community Health Services, writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. My father had a heart attack when he was pretty young. Should I be worried about having one?

A. Heart disease can run in families, but just because your father had a heart attack does not mean that you are destined to as well. Genes play a role, but so do a lot of other things such as diet, fitness level, stress level and general health. You should take a genetic risk of heart disease seriously however. The good news is that there’s a lot that you can do to reduce your risk. Some tips are obvious:

• Don’t smoke
• Exercise regularly
• Eat a diet high in fiber and low in saturated fats and sweets
• Keep a healthy weight
• Maintain normal blood pressure and cholesterol levels

Other tips are not so obvious, for instance, did you know that heart disease is associated with poor dental health? Check in with your doctor to see what precautions you should take. And never ignore any warning signs, like chest pain during exercise.

 

Varicose Veins

JoAnn Slosek, a registered nurse from Home & Community Health Services, writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. My best friend has varicose veins. She tries to hide them and only wears long pants. Is there anything she can do to shrink them?

A. Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in the legs and feet. Standing and walking upright increases the pressure in the veins of your lower body. Varicose veins usually don’t cause any pain. Signs of varicose veins include:

• Veins that are dark purple or blue in color
• Veins that appear twisted and bulging; often like cords on your legs

When painful signs and symptoms occur, they may include:

• An achy or heavy feeling in the legs
• Burning, throbbing, muscle cramping and swelling in the lower legs
• Worsened pain after sitting or standing for a long time
• Itching around one or more of the veins
• Skin ulcers near the ankle which can mean vascular disease that may require medical attention

Causes of varicose veins can include:

• Age. As one ages, veins can lose elasticity causing them to stretch. The valves in the veins may become weak, allowing blood that should be moving toward the heart to flow backward. Blood pools in the veins, which enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.
• Pregnancy. Some pregnant women develop varicose veins which generally improve without medical treatment within three months after delivery.
• Genetics. Many times varicose veins run in families.

Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue. They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider’s web.

There are some self-care measures can be taken to decrease the discomfort that varicose veins can cause. These same measures can help prevent or slow the development of varicose veins, as well. They include:

• Exercise. Get the legs moving. Walking is a great way to encourage blood circulation in your legs. A doctor can recommend an appropriate activity level.
• Watch weight and diet. Shedding excess pounds takes unnecessary pressure off your veins. Follow a low-salt diet to prevent swelling caused from water retention.
• Avoid high heels. Low-heeled shoes work calf muscles more, which is better for veins. Don’t wear tight clothes around the waist, legs or groin. Tight panty-leg girdles, for instance, can cut off blood flow.
• Elevate the legs. To improve the circulation in the legs, take several short breaks daily to elevate the legs above the level of the heart. For example, lie down with the legs resting on three or four pillows.
• Avoid long periods of sitting or standing. Make a point of changing position frequently to encourage blood flow. Try to move around at least every 30 minutes or so.
• Don’t sit with legs crossed. Some doctors believe this position can increase circulation problems.
• Wearing compression stockings is often the first approach to try before moving on to other treatments. Compression stockings are worn all day. They steadily squeeze the legs, helping veins and leg muscles move blood more efficiently.

If the veins don’t respond to self-care, compression stockings, or if the condition is more severe, the doctor may suggest one of these varicose vein treatments:

• Sclerotherapy. In this procedure, the doctor injects small- and medium-sized varicose veins with a solution that scars and closes those veins. Sclerotherapy does not require anesthesia and can be done in the doctor’s office.
• Laser surgeries. Laser surgery works by sending strong bursts of light onto the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.
• Catheter-assisted procedures. In one of these treatments, the doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter. This procedure is usually done for larger varicose veins.
• Vein stripping. This procedure involves removing a long vein through small incisions. This is an outpatient procedure for most people.
• Ambulatory phlebectomy. The doctor removes smaller varicose veins through a series of tiny skin punctures. Scarring is generally minimal.
• Endoscopic vein surgery. This operation is only used in an advanced case leg ulcers. The surgeon uses a thin video camera inserted in the leg to visualize and close varicose veins, and then removes the veins through small incisions. This procedure is performed on an outpatient basis.

 

What is a TIA?

JoAnn Slosek, a registered nurse from Home & Community Health Services writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well.

Q. My cousin was recently diagnosed with a transient ischemic attack (TIA). Is this a stroke? Should we worry that this will happen again and even be worse if it does?

A. While TIA’s are often labeled as “mini-strokes,” they are more accurately characterized as a “warning stroke,” a warning you should take very seriously.

A TIA is caused by a clot; the only difference between a stroke and a TIA is that with a TIA the blockage is temporary (transient). TIA symptoms occur rapidly and last a relatively short amount of time, most often less than five minutes. Unlike a stroke, when a TIA is over, there is no permanent injury to the brain.

The warning signs of a TIA are exactly the same as a stroke:

• Sudden numbness or weakness of the face, arm or leg – especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

Whenever one has stroke symptoms, dial 9-1-1 immediately and get to the emergency room for evaluation. Do not wait to see if the symptoms go away, time is of the essence. While most clots do eventually dissolve, the longer they stay, the more damage is made.

While the vast majority of strokes are not preceded by a TIA, about one-third of people who experience a TIA go on to have a stroke within a year. A TIA is a warning stroke and gives a patient time to act and keep a permanent stroke from occurring. By recognizing TIA symptoms and getting to the hospital, the patient can get help identifying why the TIA occurred and get treatment — either through medication or surgery — that can prevent a stroke from occurring.

If a survivor experiences a TIA after they have had a stroke, they should go to the emergency room immediately because something in their treatment plan has not worked.

There should be no difference in response to a TIA or a stroke. Although a TIA resolves itself before there is damage, there is no way to predict which clots will dissolve spontaneously. A stroke and a TIA are considered medical emergencies; dial 911 and tell the operator you think it’s a stroke, be sure to note the time the symptoms started.

Remember, time lost is brain lost.

Dentures Getting Loose?

JoAnn Slosek, a registered nurse from Home & Community Health Services writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health-related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. My dentures seem to be getting loose. Do I need to buy new ones or is there a way to fit them more properly?

A. Dentures usually need to be altered from time to time – the gums and bone supporting the dentures change over time. Relining and rebasing are ways to adjust your dentures so they fit more securely. Rebasing involves making an entirely new denture base. Relining modifies the existing base. In both procedures, the teeth that are in your denture are not changed.

Relining involves putting a new surface on the part of the denture that fits against your gums. After teeth are extracted, the bone that once held your teeth shrinks. It is common to discover that dentures no longer fit properly. If the denture is otherwise in good shape, your dentist may recommend an office reline, which takes about 30 to 60 minutes.

There are two types of relines, soft and hard – different materials are used for each. The material for soft relines remains somewhat flexible; if you were to press the material with your fingernail, you would see an impression. Resin used for hard relines does not have this flexibility.

Rebasing involves replacing the entire base of the denture, but keeping the teeth. The process is more complex than relining and requires two or three dental visits. You will be without your dentures for one to several days.

Your dentist will evaluate your situation and discuss a possible treatment plan. Make sure that you ask your dentist why he or she is proposing the treatment and how long you will be without your denture.

IBS: What it is and What to do

JoAnn Slosek, a registered nurse from Home & Community Health Services writes a health-related column in the Enfield Press, a weekly community newspaper for Enfield, CT. Her column, Ask Your Nurse JoAnn, features JoAnn’s responses to health related questions from community members, it appears twice each month in the newspaper and we will post the entries here as well!

Q. My mother has been diagnosed with irritable bowel syndrome. Can you provide me with some information regarding this disease?

A. A short bout of abdominal pain and diarrhea or constipation now and then is not unusual, but long-term or recurring symptoms are not normal. They may signal irritable bowel syndrome (IBS).

IBS is one of many conditions known as “functional gastrointestinal disorders.” In IBS, the functioning disorder is the way the nerves and muscles are working. In the doctor’s office nothing abnormal is seen on tests – the bowels look fine; yet there is pain, discomfort and other symptoms that won’t go away. Certain signs and symptoms are the basis for identifying IBS. IBS is complex – it is not a risk for life-threatening diseases, but it can have a major impact on a person’s life.

IBS Treatments Depend on Symptom Severity

Mild symptoms - occur infrequently and sometimes interfere with normal daily functioning.

Moderate symptoms - occur more intensely and frequently. They more often interfere with daily activities.

Severe symptoms – are frequent and intense and chronically interfere with daily functioning.

All IBS treatment should begin with education about the nature of the disorder　

• IBS is a long-term condition
• Symptoms flare over and over again and can change over time
• The symptoms themselves are not life threatening
• IBS is not a risk for another more serious disease

For moderate symptoms consider…

• Use of a diary to help find factors that worsen or bring on symptoms
• Stress management, gut-directed hypnosis, biofeedback, relaxation, or pain management techniques
• Consulting with your physician about the use of drug therapy

Work together with your doctor or therapist and develop your own IBS treatment plan and outcome goals. Working in partnership with a health professional can help achieve the best possible results.