Medical Voyce | Your Health Care. Your Way.

For Cindy Fowler, life at age 48 was nearly perfect. She loved her job in business development and marketing and was involved in community activities. Her daughter, a college student, was spending her junior year abroad, and Cindy planned a trip overseas.

But after she returned from Europe, Cindy felt something strange in her left breast.

Her previous mammograms were normal, but this time, there was a new ridge of tissue. A biopsy showed abnormal cells.

Her primary care physician, Dr. Kimberly Tibbs, referred her to Dr. Ingrid Sharon, a surgeon at Memorial Health System’s Breast Surgery Specialists.

“I was lucky enough to have a primary care physician who said, ‘I am not an expert in breast cancer, and I want you to see somebody who is.’ I credit her for saving my life.”

Cindy was diagnosed on Feb. 11, 2008 with multifocal cancer of the left breast.

“It was well hidden,” Cindy says. “The typical diagnostic tools did not indicate it.”

New survey reveals patients and doctors need to talk about asthma management.

If you have asthma, ask your doctor to talk with you about how to properly manage and control your condition.

That was one of the most important messages from the Asthma Insight and Management (AIM), the largest, most comprehensive survey of asthma patients and physicians in the United States in a decade. Results of the survey of 2,500 current asthma patients 12 and older, 1,004 adults without asthma, and 309 physicians in the United States, were released in November 2009.

The study showcases the burden of this chronic disease, says Dr. Robert Nathan, an allergist at Asthma & Allergy Associates and Research Center in Colorado Springs and Pueblo, and a principal adviser on the survey.

What the survey found

The pain was off the charts. Surgery was a last resort that helped get her back into action.

A month before her 28th birthday, Angela Crews was carrying a heavy piece of equipment at the photography studio where she worked. When she twisted to keep from dropping it, pain shot through her lower back.

Angela had x-rays and began physical therapy, but her pain worsened over the next three years. After consulting several orthopedic physicians and a pain specialist, she was diagnosed with degenerative disc disease—a condition that is relatively rare in a young, slim and active person like Angela. She was treated with further physical therapy, therapeutic exercise, electric stimulation, medication, steroid injections, and spinal manipulation by an osteopathic physician. But the pain remained.

Dr. Scot Lewey says gluten disorders are far more widespread than many realize.

Full-blown celiac disease affects 1 in 100 people, yet it is frequently missed or misdiagnosed as irritable bowel syndrome. That is unfortunate, Dr. Scot Lewey says, because celiac disease is contributing to the rising tide of autoimmune conditions: type I diabetes, lupus, rheumatoid arthritis, early-onset osteoporosis in women and osteoporosis in men. It causes untold misery for patients, who may suffer infertility, recurrent miscarriages, unexplained loss of sensation in the hands or feet, fibromyalgia, rashes, malnutrition, and chronic fatigue, as well as gas, bloating, diarrhea, and abdominal pain. Some celiac sufferers are so sensitive to gluten that they can go into shock and die after ingesting even a small amount. They must stringently follow a gluten-free diet.

Colon cancer screening can save your life.

If you’re over 50, talk with your doctor about colonoscopy.

When Katie Couric had a colonoscopy, America watched it on TV. Couric had her colonoscopy broadcast because she knew that colon cancer screening and polyp removal save lives.

“Colon cancer death rates are declining thanks to improved awareness and screening,” says Dr. Austin Garza of Associates in Gastroenterology, P.C. When detected early, the prognosis for colon cancer is more favorable. Yet only about half of the people who are at risk due to age or family history are being screened.

According to the American Diabetes Association, one in four people with diabetes will develop a foot ulcer during their lifetime. Because people with diabetes lose many of their defensive mechanisms and may develop numbness in their feet, unnoticed or neglected foot sores can become infected. The consequences can be drastic: About 66,000 Americans with diabetes will have a lower extremity amputation this year; others will be disabled, and some will die.

“Foot care for people with diabetes is the single most important step toward preventing infection, deformity, and amputation,” says Dr. Nicholas Sol, Podiatrist-Pedorthist at The Walking Clinic, P.C. of Colorado Springs. “In the majority of patients who suffer amputations, their problems began with a sore on the foot caused by ill-fitting shoes or an area subjected to repetitive pressure and rubbing.”

Hip and knee replacements are improving.

Better surgical techniques and new materials are speeding patients’ recovery.

Ten years ago, patients seeking total hip and knee replacement faced lengthy hospital stays, painful recoveries, and the possibility that the joint would wear out in 10 to 15 years.

Improvements in surgical technique, better pain management at the time of surgery, and new technology enable faster recoveries with less pain and the promise that the new joint will last, says Dr. Eric Jepson, a total joint specialist with Colorado Springs Orthopaedic Group.

“We are able to mobilize patients earlier than we did even five years ago. The plastics, metals, and ceramics we are using make the biggest difference in long-term outcomes,” Dr. Jepson says.

Better surgical techniques

When Dr. Rick Meinig, a surgeon with Front Range Orthopaedics, first heard news reports about the disastrous earthquake in Haiti on Jan. 12, 2010, he knew immediately that he had to do something.

“I put in an application for volunteering with the Orthopaedic Trauma Association, Partners in Health, and some other associations,” Dr. Meinig says. “I thought I would get a quick response, because they were saying there was a critical need for orthopaedic surgeons.”

Through Facebook posts, he learned that Dr. Jim Smith, a Pueblo surgeon, was already in the devastated country, helping to organize the medical personnel streaming in. He also found that a small, private hospital in Port-au-Prince was desperate for help.

Many people take it for granted that loss of muscle mass and bone density, increasing joint stiffness, and decreased reaction time are just part of getting older. Many also believe that muscle weakness, debilitation and depression are inevitable when someone has a chronic disease like osteoporosis, cancer, rheumatoid arthritis or HIV.

“We used to think that this was inevitable and that there was nothing you could do about it,” says Dr. Sander Orent, medical director of Medically Based Fitness in Boulder, Colo. “But no matter what the condition, everybody has the ability to benefit from exercise.” Dr. Orent came to this realization when his wife developed kidney failure and went on dialysis. During treatment, she became weak and depressed.

Pain in the neck or down an arm, or numbness in the fingers is enough to send many people over 50 to the doctor. It’s obvious something is wrong, especially if the pain has been going on for a while.

But sometimes, more subtle symptoms can signal a condition called cervical myelopathy, which occurs when a degenerative condition or arthritis of the small joints in the neck are narrowing the spinal canal and pressing on the spinal cord.

“Myelopathy can cause generalized weakness, poor balance, difficulty walking, difficulty with tasks that require precise use of the fingers,” says Dr. Mark Santman, an orthopaedic surgeon with Front Range Orthopaedics of Colorado Springs. “The patient just starts to feel clumsier. It’s so gradually progressive that often it gets chalked up to just getting older.”

Patients typically don’t associate some of these symptoms with a cervical spine problem.

The Cindy Fowler Story

Insights from AIM Asthma Survey

The Angela Crews Back Pain Story

Could You Be Gluten Sensitive?

Catching Color Cancer Early

Diabetics Can Develop Foot Ulcers

Good Progress Seen in Joint Replacements

Local Doctors Help in Haiti

Exercise Therapy Helps Chronic Disease and Aging

Subtle symptoms shouldn’t be ignored