Tag Archives: Eve Clayton

Joint replacement myths and facts

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Get the 411 on joint replacement from a doctor who knows. (Courtesy Spectrum Health Beat)

By Eve Clayton, Spectrum Health Beat


“You’d be shocked at how many patients come in thinking they’re too young for knee or hip replacement surgery,” said C. Christopher Sherry, DO, an orthopedic surgeon and joint replacement specialist with Spectrum Health Medical Group.


Some patients get this notion from their doctors. Others pick up the idea from friends who remember the conventional wisdom of 30 years ago—that you need to be older than 50 to qualify for joint replacement.


That’s simply not the case anymore, according to Dr. Sherry. It’s one of six common myths about joint replacements that he’d like to see dispelled.

Myth No. 1: If you’re under 50, you’re too young to have a joint replaced.

Fact: Doctors today don’t use a specific age to determine whether a patient is a good candidate for hip or knee replacement surgery. Instead, the decision depends on the levels of disability and pain the patient is experiencing.


“In the 1970s and ’80s, the parts used for joint replacements had limited life spans,” Dr. Sherry said. “Now that technology is advancing, we have better longevity of replacement parts, so we’re much more comfortable putting them in younger patients.”


Patients with severe arthritis, for example, shouldn’t have to suffer through years of debilitating pain just because they’re young, Dr. Sherry said. “Making them wait isn’t in their best interest.”


This first myth is closely related to a second.

Myth No. 2: Replacement joints wear out in 10 years or less.

Fact: Thanks to improvements in materials and surgical techniques, today’s knee and hip replacements can last up to twice as long as comparable replacements did in decades past.


“The components we’re using have improved significantly,” said Dr. Sherry. “We’re seeing an 85 percent success rate at up to 20 years—and as technology improves, we’re hoping to pass that 20-year mark.”


People are often relieved to hear this because they want to stay active as they age.


“Patients’ expectations are changing,” Dr. Sherry said. “They want to be able to do whatever they want to do.”

Myth No. 3: If you have a joint replaced, you’ll be saying goodbye to sports.

Fact: Rather than drastically limiting patients’ activities, joint replacements make it easier for people to be active in low-impact sports.


“The goal of surgery is to get patients back to their normal activities, like playing golf and tennis,” Dr. Sherry said. “Our goal is a painless joint with good functionality.”


It’s the high-impact sports like basketball and long-distance running that patients should avoid, he said, because these activities decrease the life of replacement joints.

Myth No. 4: Joint replacement surgery means a long hospital stay.

Fact: Twenty years ago, it was normal to spend up to 10 days in the hospital after joint replacement surgery, but today the average is two to three days.


“With improvements in technology and patient care, hospital stays are significantly shorter than in the old days,” Dr. Sherry said.


Most of Dr. Sherry’s patients at the Center for Joint Replacement at Spectrum Health Blodgett Hospital stay less than two days after hip or knee replacements, with a large percentage going home the day after surgery. Some patients return home the same day as surgery.


“We’re getting patients up and walking sooner—even on the day of surgery,” he said. “And we’re getting them home sooner, which is a better environment for recovery.”

Myth No. 5: You should wait as long as possible before having a joint replaced.

Fact: Waiting too long can make things worse.


“If your pain is so great that it’s hindering your ability to walk, then you’re not keeping your muscles and your extremities strong, and you could be hindering the recovery process,” Dr. Sherry said. “Waiting until the last possible moment isn’t good for you.”


Rather than waiting for their mobility and quality of life to decline, Dr. Sherry encourages patients to have their knee or hip replacement sooner. This will likely improve their outcomes.

Myth No. 6: Joint replacement surgery is highly invasive.

Fact: “Some patients think that we remove the entire knee in a knee replacement … but we’re actually taking a minimal amount of bone” before inserting the new parts, Dr. Sherry said. In knee replacement surgery, these parts consist of a metal cap for the femur, a metal base plate on the tibia and a piece of plastic in between, acting as cartilage.


Surgeons today are also using less-invasive techniques and smaller incisions to perform replacements.


So, although joint replacement is major surgery, the scope is limited, Dr. Sherry said. “It’s much less invasive than many patients think.”


Reprinted with permission from Spectrum Health Beat.



See the doctor in your PJs

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By Eve Clayton, Spectrum Health Beat

Photos by Chris Clark


Kaitlyn Jones left school early one Wednesday in January because she felt awful: headache, body ache, chills, fatigue.


It must be the flu, she thought, noting how some of her fellow cosmetology students were among the many suffering from the virus this year.


She hoped she could get a prescription to treat it. But once she got home and learned she had a 102-degree fever, the last thing she wanted to do was get back into the car and go to the doctor.


So Kaitlyn, 18, took her mom’s advice and pulled up the MedNow app on her iPad.


Within minutes, she was having a video visit with Melissa Wilson, a nurse practitioner with MedNow, Spectrum Health’s telemedicine service.


MedNow lets anyone in Michigan who has access to a smartphone, tablet or camera-equipped laptop to receive non-emergency care from a Spectrum Health provider on-screen, 24/7.


“It was kind of like FaceTime,” Kaitlyn said. “Super easy.”

No waiting room

After she signed in to the app and picked the next available appointment time—in this case, immediately—Kaitlyn connected via video chat with a MedNow medical assistant, who got her registered and verified her insurance.


Then Wilson took over the video visit, asking about Kaitlyn’s medical history and walking her through a brief physical exam. From the comfort of her family’s home in Rockford, Michigan, Kaitlyn checked her neck and ears for tenderness and tried to show Wilson the back of her throat using her iPad’s camera.


“We went through my symptoms together, and then she prescribed Tamiflu,” Kaitlyn said. “She sent it right away from there to the pharmacy, so I was able to get it that night.”


Two days later, she felt well enough to return to class.


Tamiflu, or oseltamivir, is an oral drug that can shorten the duration of seasonal influenza if you take it soon after contracting the illness. It’s not essential for all flu patients, but it was important for Kaitlyn because she has Type 1 diabetes, which puts her at higher risk for complications.

Photo by Chris Clark, Spectrum Health Beat

“I thought, we need to nip this in the bud,” said Holly Jones, Kaitlyn’s mom. “With diabetes, it’s just more complicated when they get the flu.”


Kaitlyn’s diabetes diagnosis is only a few months old, making her extra cautious about her health.


“Because I’m so new, I’m hyper aware and really scared of doing anything that would cause my blood sugars to go crazy,” she said.


The idea of sitting in a doctor’s office or urgent care center didn’t sit well with her—or her mom.


“I didn’t want her near the germy waiting room to catch whatever else was in there,” Holly said.


That’s what made the MedNow visit so ideal.


“I don’t even think you got out of your pajamas,” Holly said to her daughter.

Growing popularity

Kaitlyn’s video visit wasn’t just fast and convenient—at $45, it was also less expensive than a trip to the doctor, an urgent care center or the emergency department.


According to Amanda Reed, MedNow’s operations director, each MedNow visit saves patients and insurers more than $120, on average, compared to other sources of care. These cost savings, combined with convenience and quality of care, have propelled MedNow’s popularity.


“We reached our new high mark on January 24, with 127 patients seen in one day,” Reed said. “We had over 5,000 app downloads in the month of January alone.”


This year’s hard-hitting flu season is a catalyst for MedNow’s growth, according to Elizabeth Suing, PA, one of about 30 providers who spend at least part of their time treating MedNow patients.


“Right now, over 50 percent of the patients we are seeing in a day are flu patients,” she said.


Many of these are first-time MedNow users. But Suing predicts they’ll be back the next time they need non-emergency care—treatment for concerns like allergies, back pain, bites and stings, diarrhea, nausea and vomiting, sinus problems, sprains and strains, urinary symptoms and more.


“Patients love the telemedicine. They love the convenience of it,” Suing said. “I think it’s the way that the world is going.”


Kaitlyn’s mom, Holly, confirms Suing’s view.


“I recommend it a lot,” she said. “My friends will say, ‘Oh, but I don’t want to go to urgent care,” and I say, ‘Try MedNow. Download the app. Make an appointment.’”


Reprinted with permission from Spectrum Health Beat.


Got a pins-and-needles tingle? Here’s what it means

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Got that pins-and-needles sensation? Here’s what you need to know about when you should be concerned. (Courtesy Spectrum Health Beat)

By Eve Clayton, Spectrum Health Beat


Odds are you know the feeling: You wake up from a nap and your arm is asleep. Or your foot’s gone numb.


As you move it around, it starts to prickle and tingle. Gradually it wakes up, and a minute or two later you’re back to normal.


What’s this uncanny sensation all about? Is it normal or something to be concerned about?


The short answer is: It depends.

If it’s fleeting and infrequent

The medical term for this feeling of numbness or tingling is paresthesia, and its cause is the compression of a nerve, according to Paul Twydell, DO, a fellowship-trained neuromuscular medicine specialist with Spectrum Health Medical Group.


Paresthesia typically happens if you lie on a nerve while asleep or hold the same position for too long while sitting—like when you’re driving or reading.


If the feeling goes away quickly, this phenomenon is called transient paresthesia, and it’s typically nothing to worry about.


People will wake up with tingling in their hands and think they have a circulation problem, Dr. Twydell said, but that’s not the case.


“It’s just that a nerve is being compressed in the wrist or elbow. And the reason it happens at night is we often sleep with our wrist or elbow flexed or underneath us, or in a strange position.”


A nerve is a bundle of “wires” surrounded by a layer of insulation called myelin, Dr. Twydell explained. Myelin helps speed the movement of electricity along the nerve.


“When that myelin is compressed, that means the messages aren’t getting through very well,” he said. “A lot of times it’s when the compression is released that (the tingling) happens”—as communication is being restored along the nerve.


The nerves most prone to compression are found in the wrist, elbow, knee and upper arm.

If it’s persistent or abnormal

So when might numbness or tingling be a cause for concern? Dr. Twydell recommends that people talk to their doctor if they experience any of the following:

  • Persistent numbness or tingling in the hands. This is often a sign of carpal tunnel syndrome, which is treatable—the sooner the better to avoid severe damage and the need for surgery.
  • Tingling in the feet, especially at night. This might be an early sign of a degenerative nerve disease called peripheral neuropathy, which is most often caused by diabetes or heredity. Neuropathy isn’t reversible, but it can sometimes be slowed down, Dr. Twydell said.
  • Weakness of a limb in conjunction with numbness. This can be a sign of more severe damage to a nerve.
  • Numbness or tingling that ascends up the legs or into the abdomen. This can be a sign of spinal cord inflammation or compression.
  • Numbness involving half of the body or face. This can be an indicator of stroke, which requires emergency care. Call 911.

If you have persistent symptoms of numbness or tingling, your doctor may order a test of the nerves called electromyography, or EMG. This nerve study can help pinpoint the source of a problem and help guide treatment.


Carpal tunnel syndrome is the most common problem investigated by Spectrum Health Medical Group Neurology in the EMG lab, Dr. Twydell said.

Tips for good nerve health

Your best bet is to avoid activities that cause prolonged nerve compression, Dr. Twydell said. Change positions frequently. Get up and walk around throughout your workday.


“If nerves are compressed over and over again, you can have more persistent symptoms that can eventually lead to weakness or disability,” he said.


Here are Dr. Twydell’s tips for preventing that numb or tingling feeling in your extremities:

  • Wear wrist splints at night to ease problems with carpal tunnel syndrome.
  • Avoid lying on your elbow while sleeping, and try wearing an elbow pad to bed to keep the elbow straight.
  • Don’t cross your legs, with one knee draped over the other. That can compress the fibular nerve, which can lead to foot drop, a cause of tripping.
  • Avoid the habit of sleeping with your arm stretched out or underneath your partner. Over time this can damage the radial nerve, leading to wrist drop.
  • Avoid leaning on your elbows for extended periods. Try adding gel pads to the armrests of chairs, wheelchairs or cars.
  • If you do a lot of computer work, use a gel wrist rest. Avoid holding the wrists in either a flexed or an extended position, which can damage the median nerve.
  • Eat a well-balanced, low-carb diet. This is especially important for people with diabetes, who are more prone to neuropathies.
  • Avoid alcohol in excess, which can cause neuropathy.
  • Avoid taking zinc and vitamin B6 in excess, which can cause nerve problems.

Dr. Twydell admits that some of these tips are easier said than done. For example, it’s hard to change the way you sleep, he said. Yet, people who sleep in a way that compresses the ulnar nerve in their elbow “can cause some pretty significant weakness in the hand.”


And if you’re one of those people who rarely experiences numb or prickly limbs, consider yourself lucky. Some people are more prone to nerve compression than others, Dr. Twydell said.


Reprinted with permission from Spectrum Health Beat.

Beat the clock, reverse the stroke

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Photo by Taylor Ballek, Spectrum Health Beat

By Eve Clayton, Spectrum Health Beat

Photos by Taylor Ballek


Tramell Louis Jr. has diabetes, and his friends all know it.


So when he collapsed at lunch while waiting to place his order, his buddy thought Tramell was having a diabetic attack.


He helped him out to his car and called LaGenda, Tramell’s wife, who drove to meet them outside the restaurant.


It didn’t take her long to figure out that this was no low-blood-sugar attack, so she followed her instincts and called 911.


“I’m asking him questions and he’s looking at me, but he won’t respond. So at that point I knew something was grotesquely wrong,” she said. “I just knew it wasn’t related to the diabetes.”


As she watched “his mouth go crooked,” she wondered whether he was having a stroke.

Clot retrieval

An ambulance took Tramell to the emergency department at Spectrum Health Butterworth Hospital, where doctors confirmed LaGenda’s suspicions: At age 37, her husband had suffered an acute ischemic stroke.


The doctors quickly got him hooked up to an intravenous drip and administered a clot-busting medicine known as IV tPA. As the only drug approved by the Food and Drug Administration for treating acute ischemic stroke, this is the standard of care in a case like Tramell’s.


At the same time, emergency room staff called one of the hospital’s stroke specialists, who ordered a CT angiogram to pinpoint the source of the stroke. Tramell was rushed to the interventional radiology suite for imaging.


With the images on screen, the Spectrum Health Medical Group neurointerventionalist could see that Tramell was a perfect candidate for an advanced intervention called a mechanical thrombectomy, or clot retrieval.


Tramell’s brain scans showed two blood clots—one in the carotid artery in his neck and the other lodged in the left-middle cerebral artery, a major artery supplying the brain.


This second clot had shut down the blood flow to the left side of his brain, like a dam blocking a river.


“When the doctor showed me the CT scan of his brain, you could clearly see that (one) side of his brain had no blood flow to it at all,” LaGenda recalled.

Time is brain

With stroke, speed is everything. The longer the brain is deprived of blood, the more damage the brain suffers.


Studies have shown that for every minute blood supply is blocked, approximately 2 million neurons die.


So if a patient fits the criteria for intervention, “the sooner you start the procedure, the sooner you take out the blood clot, the sooner you restore the blood flow, the better the outcomes at three months.” That’s the standard measurement in the United States today.


Thankfully, Tramell beat the clock. From the moment he arrived at the hospital to the time he underwent surgery, less than an hour had passed.


Because there were two clots, the doctor used a two-step process to retrieve them. First he inserted a catheter into a blood vessel in the patient’s groin and fed it up to the carotid artery. Using a tool called the Solitaire device, he trapped the first clot in a tiny mesh stent and pulled it out.

Photo by Taylor Ballek, Spectrum Health Beat

Then he repeated the technique, fishing out the clot in the central brain. Immediately the blood began to flow again, in what doctors call complete recanalization—the channel was open again.


The results for Tramell proved to be dramatic.


His symptoms—loss of language function and right-side weakness—improved literally overnight, said Vivek Rai, MD, a neurologist with Spectrum Health Medical Group who specializes in stroke and vascular neurology. He took over Tramell’s care after his release from intensive care.


“After the procedure, the next morning when he woke up, he was night and day,” Dr. Rai said. “And he continued to do so well.”


Now that Tramell is in the clear, Dr. Rai will see him annually in the neurovascular program’s stroke clinic, keeping tabs on his carotid artery disease, which was the cause of the stroke, and monitoring his general health. To prevent a future stroke, Tramell will need to take aspirin and cholesterol medication, and carefully control his diabetes and blood pressure.

Driven to change

At five months post stroke, Tramell is feeling better than ever.


“I feel great. I really do,” he said. “I feel healthier than I have in a long time.”


He looks and sounds healthy, too, with no lingering effects. At least, none that a bystander would notice.


“The only problem I have is my speech,” he said. “When I speak, if it’s a word I haven’t used after I had my stroke, it takes—it’s like a pause and then I have to remember the word and then it jogs it, and then I start using it fluently.”


The stroke served as a major wake-up call for the father of two. Realizing his life could be snatched from him—separating him from his wife and children—brought out strong emotions.


“I felt anger, extreme anger—with myself. I just knew I had to change. I had the worst—the worst—eating habits in the world,” he said, noting that before he started taking insulin, he weighed over 300 pounds.


Today Tramell is eating better, faithfully taking his medications, drinking more water, kicking his soda habit and “running on a treadmill like crazy”—even when his job as a shipping and receiving clerk keeps him at work late.


“My wife—she’s the one that motivates me to do all the things I do,” he said.


Reprinted with permission from Spectrum Health Beat.


What’s it going to take—a break?

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Keep osteoporosis at bay with exercise, calcium, vitamin D and other healthy habits. (Courtesy Spectrum Health Beat)

By Eve Clayton, Spectrum Health Beat


If someone asked you to name the silent disease that affects half of all adults age 50 and older, what would you say?


Would you say osteoporosis?


That’s the answer we’re looking for. But not many people—doctors or patients—give the bone-weakening disease the attention it deserves, according to Jodi Hamblin, MD, a bone health specialist.


“Osteoporosis is a lethal disease that is frequently ignored,” Dr. Hamblin said, explaining that the disease signals a problem with both the quantity and the quality of bone.


In the United States alone, half of adults age 50 and older either already have osteoporosis or are well on their way to developing it.

Silent and overlooked

The trouble is, osteoporosis doesn’t have symptoms, so most people don’t know they have it until they break a bone.


And even then, many patients don’t realize that osteoporosis was the cause of their fracture—when in fact, a low-trauma fracture almost always indicates osteoporosis in older adults.


“After 50, if you fall from a standing position and you break a bone, excluding your hands and feet, then you have osteoporosis,” Dr. Hamblin said. This type of break is called a fragility fracture.


Osteoporosis can also be diagnosed when a bone density test reports low bone density.

Research suggests doctors and patients tend to overlook the threat of osteoporosis.


According to a 2016 study by Northwell Health in New York, more than two-thirds of patients who suffered a hip fracture said their doctors didn’t tell them they have osteoporosis, and more than half said they weren’t given medication to treat osteoporosis after their fracture was treated.


This lack of information and follow-up is a huge problem, the study’s senior author said, because of the seriousness of hip fractures.


“You can die after a hip fracture, and you’re at great risk of prolonged complications,” said author Gisele Wolf-Klein, MD, in a statement. “You can also be left as an invalid—a fear of many older adults.”


Six months after suffering a hip fracture, only 15 percent of patients can walk across a room without help, according to the National Osteoporosis Foundation.

Getting on top of the problem

Bringing more attention to the prevention and treatment of osteoporosis is the goal, said Dr. Hamblin.


By following up after a break and treating the cause of the bone loss or poor bone quality, doctors can help prevent future fractures.


Patients are more likely to sustain a secondary fracture if they are not treated for their osteoporosis, Dr. Hamblin said.


High-risk patients include:

  • Heart and lung transplant patients, who are at risk because the anti-rejection medications they take are bone weakening
  • Breast cancer patients, who are on estrogen-preventing medications that can cause bone loss
  • Gastric bypass surgery patients, who typically have bad absorption of nutrients so don’t get sufficient calcium and vitamin D—two essential nutrients for bone health
  • Cystic fibrosis patients
  • End-stage COPD patients

The care plan includes balance testing, nutritional counseling, bone density testing, blood and urine testing to identify risk factors, and medication review and management.

“Sometimes medications taken for other conditions can get in the way of calcium absorption or directly weaken the bone or even contribute to dizziness,” which can increase a patient’s risk of falling, Dr. Hamblin said.


Physical therapy can help people learn how to build bone through exercise and how to prevent falls, which are responsible for 90 percent of hip fractures.


“Fall prevention is half the battle,” Dr. Hamblin said. “If you have weak bones and you don’t fall, you may never break.”

Osteoporosis risk factors

In addition to the medical issues listed above, several other factors can put you at risk for bone loss and poor bone strength. Risk factors include:

  • Advanced age—this applies to both women and men, though the incidence of osteoporosis is higher in aging women because of a drop in hormone levels
  • Diabetes
  • Steroid use (5 or more milligrams a day for three months or longer)—this lowers bone quality in men and women equally
  • Overactive thyroid or parathyroid activity
  • Cigarette smoking
  • Regularly drinking more than two alcoholic beverages a day
  • Lack of appropriate exercise
  • Low calcium intake
  • Vitamin D, vitamin B12 or folic acid deficiency

“There’s an extensive list of causes for bone loss and for poor bone quality,” said Dr. Hamblin. “If we can get those conditions in order, sometimes that’s all we have to do.”


When medications are called for, doctors have a variety of options based on the patient’s situation. For example, some patients need medications that help build new bone, while others need medications to prevent bone loss.


The aim is to decrease the risk of fracture by keeping bone loss in check and by limiting the risk factors for poor bone quality.

A preventable disease

Of course, prevention is the best course of action, and osteoporosis is very preventable, Dr. Hamblin said.


“If we could get kids and young adults to improve their dietary calcium intake and have a good exercise program, that would be huge,” she said. “And if we could eliminate smoking and excessive use of alcohol, that would make all the difference for most people.”


Reprinted with permission from Spectrum Health Beat.


Reclaiming her spark

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By Eve Clayton, Spectrum Health Beat, photos by Taylor Ballek


If you were to meet Judy Pellerito today, you would say she’s full of life.


Newly retired after 31 years of teaching, the Kentwood, Michigan, resident is animated, outgoing and full of dreams.


She’s starting a community choir “open to anyone ages 13 to 103.” She plans to play her ukulele for nursing home residents and bring her pup Mabel along as a therapy dog.


So Pellerito would agree with you: At age 54, her life is good.


“I have energy and hope and optimism and gratitude,” she said on a recent fall morning.


But wind the clock back a year or two and get Pellerito to level with you, and you might hear a different story. A story marked by anxiety, depression, poor sleep and low energy.


Sure, she still got up and went to school every day. The former Northview High School choral director loved teaching, loved her students and her colleagues.


But it became harder and harder to summon the “energy and the stamina and find the joy day after day,” she said.


Finally a good friend saw through her smiling façade and nudged her to get help. To find out what was going on. Tired of saying, “I’m fine, I’m fine,” Pellerito acquiesced.


She made an appointment with a psychologist, who listened as Pellerito talked about life—and heard her describe many of the classic symptoms of menopause.

Hormone decline

Pellerito’s counselor referred her to Marjorie Taylor, NP, a member of the Spectrum Health Midlife, Menopause & Sexual Health team who specializes in hormone-related issues.

Photo by Taylor Ballek

Recognizing her symptoms as typical of a woman going through midlife hormonal changes, Taylor did a physical exam and a thorough blood workup, paying close attention to Pellerito’s thyroid and other hormone levels.


Not surprisingly, Pellerito’s blood levels showed that “her estrogen was really low,” Taylor said.


Taylor’s message for her patient? There’s help for you. You don’t have to struggle.


Taylor started Pellerito on an antidepressant and hormone therapy tailored to her medical situation. After just five months, Pellerito felt like herself again—or, perhaps, like a more jubilant version of herself.


“I didn’t know that my hormones had bottomed out,” she said. “It’s not like there is a switch that’s flipped—you don’t one day get symptoms. It’s so gradual that it’s almost imperceptible. You don’t realize until you look back.”


In retrospect, Pellerito says her menopause symptoms probably escalated over the course of five to 10 years, gradually stripping away her joy.


“I can look back now and just see an incredible difference,” she said. “And an incredible future.”

Feeling good again

Stories like Pellerito’s fuel Taylor’s enthusiasm for her work.


“It’s so fun to do because every visit you see improvement, and you see this person find their spark again,” she said. “When everything gets balanced, whether it’s thyroid, hormones, whatever it is, we see not only their energy come back, but they sleep better. It helps relationships, it helps—just their whole quality of life improves.”


Taylor acknowledges that hormone therapy isn’t right for everyone, but as a strong advocate of its benefits, she gives her patients lots of information and works hard to clear up the misperceptions about its risks.


“People have no clue of the wonderful benefits that hormone therapy can bring,” she said.

Photo by Taylor Ballek

Hormone therapy can contribute to women’s longevity, Taylor said, by preventing heart attacks, strokes and osteoporosis, and by helping to alleviate fatigue, depression, anxiety, vaginal issues and bladder issues.


“But the biggest thing is that it brings the spark back to their life and they feel normal again,” she said. “When people start going through perimenopause, they think, ‘Ugh, I’m aging and I’m just never going to feel good again. … And that’s not true.”

Start sooner

Pellerito’s experience is a vivid case in point. She now feels healthy, both physically and emotionally, and is eager to explore new opportunities as a young retiree.


Once a week she returns to her previous school district to work as a vocal coach.


“I’m still pouring love into teenagers and adults in different ways,” she said, “but everything is different now.”


For other women who may be feeling some of the symptoms she experienced, Pellerito says not to wait like she did.


“I would just recommend people walk down the path of getting help sooner,” she said. “Sooner, sooner.”


Reprinted with permission by Spectrum Health Beat.

Fibromyalgia myths and facts

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Connie Gall, whose fibromyalgia led to her early retirement, has found a new sense of purpose in the adoption and care of older dogs. She’s pictured here with her dog Prince. (Courtesy Spectrum Health Beat)

By Eve Clayton, Spectrum Health Beat

 

What do actor Morgan Freeman and Irish singer-songwriter Sinead O’Connor have in common with Connie Gall, a retired college financial aid officer?

 

All three suffer from fibromyalgia, a chronic pain disorder with debilitating effects.

 

Gall, 59, has lived with fibromyalgia since 1990. Just four months after having back surgery that year, she was in a car accident that gave her severe whiplash.

 

The whiplash triggered a series of symptoms: migraines, widespread joint and muscle pain, TMJ trouble, restless legs, burning and cold skin sensations, sleep problems, fatigue, tinnitus and polyneuropathy.

 

Although Gall’s symptoms began 28 years ago, it wasn’t until 2004 that a rheumatologist connected the dots and diagnosed her with fibromyalgia.

 

Joshua Brinks, NP, is a family nurse practitioner who works in the Spectrum Health Medical Group East Grand Rapids Family Medicine office and specializes in working with fibromyalgia patients. He and Gall, one of his patients, would like to shed some light on fibromyalgia and debunk some of the common myths associated with it.

Myth No. 1: Fibromyalgia isn’t real, it’s all in your head.

Fact—Fibromyalgia is a central nervous system pain processing disorder.

 

“It’s a chronic pain syndrome,” Brinks said. “We don’t know what causes it and we don’t have a cure. And so for patients to actually have a name (for their disorder) and to know that … it’s not in their head is very comforting or relieving to them.”

 

Gall agrees. When she finally found a doctor who “could put a name on what was going on with me, it made me feel validated … and it all started to make sense,” she said. “It’s (your) central nervous system playing games with you.”

 

In the last decade, more and more health care providers have accepted and acknowledged the reality of fibromyalgia, Brinks said.

 

“That’s a big step,” he said.

 

The next challenge is getting more people to understand it.

 

“It’s hard to explain to people it’s something that’s going on in your brain—that it’s your central nervous system that is controlling how you feel pain,” Gall said.

Myth No. 2: Health care providers diagnose fibromyalgia when they can’t find a “real” diagnosis.

Fact—There are defined diagnostic criteria for fibromyalgia. If a patient meets these criteria and if other diseases are ruled out, the diagnosis is quite clear.

 

“I can diagnose it in a single visit,” Brinks said, giving two main diagnostic criteria:

  • Widespread pain above and below the waist on both sides of the body for three months or longer.
  • Eleven out of 18 classic tender points—again, above and below the waist on both sides of the body.

“There’s no blood test for it, although sometimes we do a blood test to rule out other things that can mimic it,” Brinks said.

Myth No. 3: If your muscles hurt so much, there must be something wrong with them.

Fact—The problem isn’t in the muscles themselves, but in the way the brain is interpreting signals.

 

“The fact is,” Brinks said, “they’ve done studies to look at the muscle fibers, they’ve looked at biopsies, pathology studies—they can’t find anything wrong here.”

 

So if you have fibromyalgia, you need to “retrain your brain into thinking that if (your) husband gives (you) a hug and that causes pain, it’s not actually causing harm to the tissue,” he said.

Myth No. 4: Fibromyalgia is a syndrome that affects only women.

Fact—Between 10 and 20 percent of fibromyalgia patients nationwide are men, according to the National Institutes of Health.

 

These statistics match the patient demographics Brinks sees in his practice.

Myth No. 5: Fibromyalgia is rare.

Fact—Experts estimate that more than 5 million adults in the United States have it.

 

“It’s actually one of the most common pain disorders,” Brinks said.

Myth No. 6: Fibromyalgia is hopelessly untreatable.

Fact—Although fibromyalgia has no cure, several treatments can be helpful. Patients respond best if they keep a positive attitude and try various treatments to find what works for them. Brinks mentioned several:

 

Education

 

This is where treatment should start for every patient, said Brinks, who spends extra time helping newly diagnosed patients understand what he knows about fibromyalgia.

 

Gall advises people to find out as much as they can about their illness and its symptoms.

 

“One of the things that helped me was to really learn about it,” Gall said. “I found reading about it, understanding what all these things are, it made them less scary.”

 

Maximize sleep

 

Almost all patients with fibromyalgia experience non-restorative sleep.

 

“We don’t necessarily know why, but … the quality of their sleep is not good, so they wake up feeling tired,” Brinks said. The result: intensified pain.

 

Brinks tries to help patients develop good sleep behaviors and patterns. He also looks for underlying sleep disorders, such as obstructive sleep apnea, and works to treat them.

 

Low-impact aerobic exercise

 

Using an elliptical machine, swimming, riding a bike, going for a fast-paced walk—any of these exercises can improve a patient’s sleep and mood, and they can also reduce pain. “Initially it makes your pain a little worse, but then it gets better with time,” Brinks said. Activities like yoga and tai chi can help, too.

 

Cognitive behavioral therapy

 

Try a multidisciplinary approach to treatment, Brinks suggested. Working with a therapist or pain psychologist, some patients experience improvement through relaxation and breathing techniques or through guided imagery.

 

Drug therapy

 

Brinks often starts patients on a low dose of amitriptyline, which can help improve sleep and pain. He might also prescribe drugs that block the reuptake of serotonin and norepinephrine in the brain, which can help improve a patient’s mood and reduce pain. Some patients also find that anticonvulsant medicines help reduce pain.

 

The medications’ effectiveness can vary from patient to patient. “Sometimes it’s just one drug, sometimes it’s a combination,” Brinks said.

 

But narcotics are not in the mix: “Research has shown over and over again that narcotics do not help fibromyalgia,” he said.

 

Address underlying mood disorders

 

Treating anxiety and depression, which often go hand in hand with fibromyalgia, can ease the burden of living with the disorder.

 

Well-balanced diet

 

Gall is a firm believer in eating right.

 

“I don’t know what shape I’d be in if I didn’t eat so well,” she said. “If you let that slide, it’s like a domino effect.”

 

Overall, attitude makes a big difference for people with fibromyalgia, she said.

 

“I love life. I think this is a pretty cool place to be, and if you’re always talking to the people you run into about the latest thing your doctor has told you to do, that means you’re concentrating on your condition,” she said.

 

“Except for those days when I’m screaming through those stabbing pains or curled up like a ball with a migraine for three days, I’m going to try to do the rest of life with a smile on my face,” she said.

 

Brinks said people who have good attitudes and a willingness to try new things will experience better outcomes.

 

Three P’s

 

One strategy Brinks recommends is the “three P’s” approach:

  • Prioritize—“If you have a day off work and you have 12 errands you want to run, you need to shorten that list,” Brinks said. “What are the things that are most important?” If you take on too much, the stress can impact your sleep and “all of that is like the perfect storm for fibromyalgia to flare up,” he said.
  • Plan—Based on your priorities, think about how you should approach your tasks and what’s reasonable to expect of yourself.
  • Pace yourself—If you have three errands to run, don’t try to do all of them in the first two hours. Space them out, Brinks said. Gall told of a day when she didn’t pace herself as she prepared the house for a family gathering. She ended up in so much pain, she could hardly enjoy the party.

Above all, Brinks said, don’t let pain rule your life. Recognize there will be good days and bad, and remind your brain that your pain is “not life threatening—it’s annoying and frustrating, but it’s not going to cause terminal illness,” he said.

 

Still, it may bring about major life changes. For Gall, the pain and other symptoms of fibromyalgia became so bad she eventually had to retire early from a job she loved.

 

Looking to fill the void, she and her husband began adopting older dogs from animal shelters, giving them a safe home in their later years. The sense of purpose this gives her is a tremendous help, Gall said.

 

After decades with fibromyalgia, she’s found the best strategy is to face it with grit and resolve.

 

“Even if I have to do life in pain every day, ranging from a pain level 3 to a pain level 10, I don’t get to go back and do it again,” she said, “so I’m going to try to be as good at it as I can.”

 

Reprinted with permission from Spectrum Health Beat.

 

 

Flu is on the rise

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The flu hasn’t reached epidemic levels in Michigan just yet, although it has spread in other states, so there’s still time for vaccinations. (Courtesy Spectrum Health Beat)

By Eve Clayton, Spectrum Health Beat

Flu season hasn’t hit Michigan hard yet, but it’s definitely here.

That’s the word from Daniel McGee, MD, a hospitalist with Spectrum Health Helen DeVos Children’s Hospital.

The influenza virus has reached epidemic levels in other states, Dr. McGee said, explaining that a moderate level of flu is popping up regionally.

“We’re not seeing a ton of it … which may mean that people are getting their flu shots,” he said.

For kids and adults who haven’t had a flu shot this season, it’s not too late.

“The good news is there’s still time to get a flu shot. But get it soon, because it takes two weeks to take effect,” Dr. McGee said.

Time will tell if the vaccine is a good match to the type of flu circulating this year, or how bad of a flu season it will be. So far, 11 children have died from the flu in the United States this 2018-19 flu season. For the 2017-18 flu season, 185 children died.

“It’s early yet,” Dr. McGee said, emphasizing the importance of the vaccine and getting immediate care for the flu.

If you suspect you or your family member has the flu, call your doctor right away, Dr. McGee said, because the medication Tamiflu can treat it—but you have to start taking it early in the course of the illness.

Flu symptoms include fever, coughing, headache, muscle aches and tiredness. Symptoms generally last five to seven days.

Bottom line? Get your flu shot—it’s really the best thing you can do to prevent the illness.

Beyond that, it’s what your mom always told you: Wash your hands thoroughly and frequently as you and your family practice good hygiene.

“That’s really the best advice,” Dr. McGee said. “That, and get your flu shot.”

To find a flu clinic near you, use the Flu Vaccine Finder—a blue box on this page from the Centers for Disease Control and Prevention. If you think you have the flu, get seen today with a MedNow appointment. To arrange a video visit, call 844.322.7374.

Reprinted with permission from Spectrum Health Beat.

 

A leg up for caregivers

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By Eve Clayton, Spectrum Health Beat; photos by Chris Clark

 

Kathy Earle had her right hip replaced the first Monday in June. Two days later, she found herself recovering at home and ready to climb the 14 stairs to her second-floor bedroom.

 

With her daughter, Emily Adamczyk, behind her for support, Earle, 62, recited the rule she learned from the staff at Spectrum Health Blodgett Hospital, where she had her surgery: “Up with your good leg first, down with your bad leg first.”

 

The mother and daughter had picked up that tip and many others when, a few weeks before her surgery, they attended a joint replacement class for patients and their caregivers.

 

Adamczyk heard this tip again just before discharge, at a new class offered for caregivers of hip and knee replacement patients.

Ready to go

Photo by Chris Clark, Spectrum Health Beat

The pre-discharge class packs a lot of information into a half hour, including cautions and reminders. The class made Adamczyk more comfortable with the idea of being her mom’s at-home caregiver.

 

“Seeing what she was capable of in the hospital was great, but then it was like, ‘Oh boy, now I have to support her by myself,’” she said. “To have a chance to sit down and hear it all again in class was really helpful.”

 

In addition to providing information about helping patients move around safely, the class—co-taught by a registered nurse and a physical or occupational therapist—covers several other topics, including:

  • Wound care
  • Pain medications and pain management
  • Preventing blood clots, infections, constipation and falls
  • When to seek medical help
  • Alternatives to the emergency department, such as orthopedic urgent care centers

The orthopedics team rolled the class out in March to give caregivers more confidence as they take their loved ones home, according to Liz Schulte, MSN, RN, nurse manager.

 

“Our patients are seeing shorter and shorter times in the hospital, and when they go home they still have a long road of recovery ahead,” Schulte said. “So to prepare that caregiver, who will be the one helping them with their medications, helping them ambulate—all of these hands-on things—it better sets them up for success.”

 

Consulting her class notes at home helped, too, Adamczyk said. When her mom’s leg began to swell, she checked a class handout to confirm that swelling is a normal part of the healing process.

 

“I think that if I didn’t know that, I would have been nervous,” she said.

 

Spectrum Health’s joint replacement program is one of the largest in the country and one of the first that The Joint Commission certified for total hip and total knee replacements.

 

“Part of the certification process is looking at your whole program and looking at what you can improve,” Schulte said, noting the program’s recent re-certification. The joint replacement discharge class is a step toward improved patient outcomes.

Freedom from pain

From Earle’s perspective, her outcome has been “amazing.” Just nine days after surgery—about a week ahead of schedule—she abandoned her walker and began using a cane to get around the house.

 

“Each day there’s something that gets a little easier. Each day it gets stronger,” said Earle, a retired elementary school teacher who lives outside Rockford, Michigan. “It’s amazing what the human body can do.”

 

Photo by Chris Clark, Spectrum Health Beat

Her right hip replacement has gone so well that she even plans to ask her surgeon, Thomas Malvitz, MD, about moving up the date of her eventual left hip replacement, she said. After dealing with arthritis pain for more than two years, she’s excited about the prospect of being free of pain.

 

“She loves to travel and has gone a lot of places with this sore hip, but it has slowed her down a lot,” Adamczyk said. “It was affecting her quality of life.”

 

Once Earle’s post-surgery driving restriction is lifted, one of her first trips this summer may well be to Lake Michigan.

 

“I definitely am looking forward to walking on a beach,” she said. “I think that would be an awesome thing.”

 

Experiencing knee or hip pain? Schedule an appointment with Spectrum Health Medical Group Orthopedics at 616.267.8860. Spectrum Health Blodgett Hospital is a recipient of the Healthgrades Joint Replacement Excellence Award and is among the top 5 percent in the nation for joint replacement.