A Solution for Damaged Rotator Cuffs and Shoulders: Reverse Shoulder Prosthesis

by: Ryan Cordry, DO, MBA with Medical West UAB, Orthopaedic Surgery

Throwing a football with kids and grandkids, swinging a tennis racket, hammering a nail, or just getting a plate from the cabinets - all involve lifting your shoulder. And when your shoulder's giving you problems, it can make for an uncomfortable life.


In general, the shoulder works as a ball-and-socket joint with three main bones: the upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). Normally, the joint is supported by muscles around the shoulder, and its movement is created and controlled with interactions of over thirty muscles, tendons, and ligaments.


With this, the rotator cuff is a group of these muscles and tendons that enable the arm to be lifted, reach overhead, and do the activities (and others) listed above. When the rotator cuff is damaged, the joint can become unstable, which will restrict the range of motion. This out-of-balance joint will wear down the cartilage between the bones, causing pain known as osteoarthritis.


If this pain and lack of motion range is just too much for the individual (whether in pain or in lifestyle adjustment), there have been limited surgical options for people with sever deterioration of the shoulder joint, as conventional shoulder implants couldn't address both the arthritis and rotator cuff damage.


But thanks to advancing technologies, there is an option that addresses both the painful arthritis and the damaged rotator cuff. It the the Reverse Shoulder Prosthesis. It looks a little bit like a handheld shower head, but the head looks up at roughly a 45 degree angle. Made of metal and polyethylene, the prosthesis replaces the damaged joint and mimics the original shoulder's anatomy, but with a deeper socket to stabilize the joint.


With the Reverse Shoulder Prosthesis, the patient has a greater potential for a greater range of motion compared to conventional shoulder implants.


Physical therapy is conducted in recovery until the patient can resume daily activities and the muscles are back up to strength, and patients are able to return to activities within a few months.


If you've experienced increasing pain and difficulty with your shoulder (or both), talk to your doctor about what options you may have. They will assess your shoulder's current situation, and if they recommend a joint replacement, be sure you ask about a Reverse Shoulder Prosthesis - it could be the key to getting you back to a fully functional, pain-free lifestyle.

Take Care, Dr. Ryan Cordry 

IMPORTANT MESSAGE FROM ALABAMA BOARD OF NURSING:

As of 7/24/14, about 24% of Alabama RNs have not submitted verification of proof of legal presence or citizenship. Also, if you look at the numbers on the chart below, a significant number have not met all the requirements for renewal.

Renewal begins September 1, 2014 so completing your CE requirements, citizenship/legal presence proof and mandatory CE (if required) should be a priority. As you can see from the chart below, only 27.72% or 19,955 RNs have all the requirements to renew as of July 21, 2014. Please share this information with your colleagues

 

If you want to check to see that your citizenship/legal presence has been verified, you can do so by going to https://www.abn.alabama.gov/abnonline/MyprofileLogin.aspx. 

Login with your license number and last four digits of your social security number. Logging in brings you to your profile. Look at the last item under your name section and if your citizenship/legal presence has been verified it will say “Yes.” You should also check to see if your address is correct and if it is not, change it now rather than waiting for renewal.


Renewal notices will only be sent to the email address of record. Mailing of renewal notices will no longer occur. Be sure the Board has your correct email address so that you will receive notices. Thanks!

Alabama RN Renewal Status

 Total # of RNs (Active / Active Probation): 71,992

 Total # of LPNs (Active / Active Probation): 16,815

*************************	Count	Percentage
Total # Renewed:	0 out of 71,992	0.00%
Total # Renewed Active/Probation:	0	0.00%
Total # Renewed Retired:	0	0.00%
Total # Eligible To Renew (meet all conditions):	19,955 out of 71,992	27.72%
Total # Verified:	54,812 out of 71,992	76.14%

 

 

*************************	Count	Percentage
Total Missing CE:	49,402 out of 71,992	68.62%
Missing Mandatory CE:	4,174 out of 71,992	5.80%
Total With Unpaid Fee:	319 out of 71,992	0.44%
Total Missing Verification:	17,617 out of 71,992	24.47%

 

 * Numbers as of: Jul 21 2014 8:02AM ** This report will run Sept. - Dec.

N. Genell Lee, MSN, RN, JD
Executive Officer
Alabama Board of Nursing

Appeals Court Panel Deals Blow to Obamacare

A federal appeals court dealt a potentially major blow to President Obama's healthcare law yesterday.

http://www.usatoday.com/story/news/politics/2014/07/22/obama-health-care-court-ruling/12482127/

Blood Donation Opportunities_ Aug 1-15 (counties cities and times)

Blood Donation Opportunities
August 1-15, 2014

Media contact: Alicia Anger (205)994-7723 @RedCrossACGC redcrossblood.org


The American Red Cross calls on eligible donors with all blood types to help maintain a sufficient blood supply this summer


The American Red Cross encourages all eligible blood donors to make an appointment to donate blood soon to help prevent a shortage.

During the summer months, on average, about two fewer donors give blood at each Red Cross blood drive than what is needed to meet the needs of patients. Vacations and summer activities are among the reasons regular donors may not find the time to give. But, patients don’t get a vacation from needing blood – the need is constant.


As a national network, the Red Cross has a unique responsibility to help ensure blood is available for patients whenever and wherever it is needed. By donating blood or platelets through the Red Cross, donors may be helping patients in their community or patients across the nation.


Red blood cells have a shelf life of only 42 days and platelets just five days, so they must constantly be replenished.


To learn more and make an appointment to donate blood, visit redcrossblood.org or call 1-800-RED CROSS.


Upcoming blood donation opportunities:

Autauga
Prattville 8/13/2014: 10:00 AM - 2:00 PM: Autauga County Employees, 135 North Court Street

Baldwin
Daphne 8/13/2014: 12:00 PM - 5:00 PM: City of Daphne, 1705 Main Street Gulf Shores 8/12/2014: 11:00 AM - 4:00 PM: The Hangout, 101 E Beach Blvd Robertsdale 8/3/2014: 7:00 AM - 12:00 PM: St. Patrick's Catholic Church, 23035 Highway 59 South

Calhoun
Oxford 8/7/2014: 12:00 PM - 5:00 PM: Quintard Mall Routine Mobile Operation Site # 2, 700 Quintard Avenue 8/11/2014: 1:00 PM - 6:00 PM: ERA King, 1580 Hillyer Robinson Industrial Pkwy S 8/14/2014: 12:00 PM - 5:00 PM: Quintard Mall Routine Mobile Operation Site # 2, 700 Quintard Avenue 8/16/2014: 9:00 AM - 2:00 PM: USAgencies, 601 Snow Street

Cherokee
Centre 8/5/2014: 10:00 AM - 3:00 PM: Recreation Outreach Center Centre, 300 East Chestnut Bypass 8/8/2014: 11:00 AM - 3:00 PM: Walmart Supercenter Centre, 1950 W. Main Street

Clarke
Grove Hill 8/7/2014: 10:00 AM - 2:00 PM: Alabama Department of Transportation, 129 Grove Hill Ave. East Thomasville 8/5/2014: 1:00 PM - 6:00 PM: Thomasville United Methodist Church, 120 Old Highway 5 North

Coffee
Enterprise 8/6/2014: 10:30 AM - 2:30 PM: Medical Center Enterprise, 400 North Edwards Street

Conecuh
Evergreen 8/7/2014: 1:30 PM - 5:30 PM: Evergreen Medical Center, 101 Crestview Avenue

Covington
Andalusia 8/11/2014: 11:00 AM - 4:00 PM: PowerSouth Energy Cooperative, 2027 E. Three Notch Street Florala 8/1/2014: 12:00 PM - 4:00 PM: Florala Health & Rehabilitation, 23621 Goldenrod Ave.

Cullman
Cullman 8/8/2014: 1:30 PM - 5:30 PM: Walmart Supercenter, 626 Olive St

Dallas
Selma 8/13/2014: 1:00 PM - 6:00 PM: Northside Baptist Church, 2950 Citizens Parkway Highway 22

Elmore
Millbrook 8/2/2014: 11:00 AM - 4:00 PM: Lake Elam Missionary Baptist, 3268 William Ashley Drive Wetumpka 8/7/2014: 12:30 PM - 5:30 PM: First Baptist Church Wetumpka, 205 West Bridge Street

Escambia
Brewton 8/8/2014: 2:00 PM - 7:00 PM: New Beginnings Worship Center, 717 Nicholas Ave.

Etowah
Gadsden 8/6/2014: 2:00 PM - 7:00 PM: First United Methodist Church Gadsden, 115 S. 5th Street 8/10/2014: 12:00 PM - 5:00 PM: Southside Baptist Church - Etowah, 3975 Hwy 77 South 8/14/2014: 11:30 AM - 3:30 PM: Etowah County Routine Mobile Chapter Building, 405 South First St.

Houston
Ashford 8/12/2014: 11:30 AM - 4:30 PM: Alabama Power - Ashford, 518 N Broadway Street Dothan 8/11/2014: 12:30 PM - 5:30 PM: St. Columba Catholic Church, 2700 West Main Street

Jackson
Scottsboro 8/1/2014: 11:00 AM - 4:00 PM: Walmart Supercenter, 24833 John T. Reid Pkwy

Jefferson
Birmingham 8/3/2014: 7:30 AM - 12:30 PM: Bluff Park United Methodist, 733 Valley Street 8/15/2014: 11:30 AM - 4:00 PM: Greater Birmingham Humane Society3, 300 Snow Drive

Lauderdale
Florence 8/1/2014: 1:00 PM - 6:00 PM: Woodlawn Church of Christ - Florence, 101 Co Rd 323 8/4/2014: 12:00 PM - 5:00 PM: Florence - Lauderdale Public Library, 350 North Wood Avenue 8/6/2014: 1:00 PM - 6:00 PM: Highland Baptist Church, 219 Simpson Street 8/8/2014: 1:00 PM - 6:00 PM: Woodmont Baptist Church, Woodmont Baptist Church 2001 Darby Drive 8/14/2014: 10:30 AM - 3:30 PM: First United Methodist Church, First United Methodist Church 415 N. Seminary Street Lexington 8/12/2014: 1:00 PM - 6:00 PM: Lexington High School, Lexington High School 101 School Street

Lawrence
Hillsboro 8/4/2014: 1:00 PM - 6:00 PM: Harmony Baptist Church, Harmony Baptist Church 3461 County Road 170

Lee
Opelika 8/6/2014: 12:00 PM - 4:00 PM: American Red Cross, 206 26th Street

Limestone
Ardmore 8/3/2014: 12:00 PM - 4:45 PM: Mable Hill Baptist Church, 3770 Ready Section Road

Madison
Huntsville 8/1/2014: 1:00 PM - 6:00 PM: Bruster's Ice Cream - Huntsville, 2100 Cecil Ashburn Drive 8/7/2014: 2:00 PM - 7:00 PM: University Center, 301 Sparkman Drive 8/12/2014: 8:00 AM - 1:00 PM: AMTEC Corporation, 500 Wynn Drive, Suite 314 8/12/2014: 9:00 AM - 2:00 PM: Raytheon - Jan Davis Drive, 401 Jan Davis Drive 8/13/2014: 1:30 PM - 6:30 PM: Twickenham Church of Christ, 7500 Whitesburg Drive Madison 8/10/2014: 9:00 AM - 2:00 PM: Good Shepherd United Methodist Church, 1418 Old Railroad Bed Road

Mobile
Mobile 8/14/2014: 12:00 PM - 7:00 PM: Bebo's Mobile, Bel Air Mall Target Wing 3150 Bel Air Mall 8/15/2014: 12:00 PM - 7:00 PM: Bebo's Mobile, Bel Air Mall Target Wing 3150 Bel Air Mall

Monroe
Monroeville 8/8/2014: 10:00 AM - 3:00 PM: Cadence Bank, 780 South Alabama Avenue

Montgomery
Montgomery 8/15/2014: 2:00 PM - 7:00 PM: Sam's Club - Montgomery, 1087 East Blvd

Morgan
Falkville 8/7/2014: 1:00 PM - 6:00 PM: Summerford Nursing Home, 4087 Hwy. 31 SW

Pike
Troy 8/6/2014: 2:00 PM - 7:00 PM: Park Memorial United Methodist Church, 750 Elba Highway

Russell
Phenix City 8/10/2014: 10:00 AM - 3:00 PM: Mount Olive Baptist Church, 1 Nuckols Road

Saint Clair
Pell City 8/15/2014: 11:00 AM - 4:00 PM: BB&T Pell city, 2203 First Ave. North

Shelby
Columbiana 8/1/2014: 1:00 PM - 6:00 PM: First Baptist Church of Columbiana, First Baptist Church of Columbiana 208 North Main Street 8/2/2014: 9:00 AM - 2:00 PM: First Baptist Church of Columbiana, First Baptist Church of Columbiana 208 North Main Street 8/6/2014: 10:00 AM - 3:00 PM: Shelby County Board of Education, 410 East College Street

Talladega
Talladega 8/6/2014: 10:00 AM - 3:00 PM: Coosa Valley Electric, 69220 Hwy 77

Tuscaloosa
Tuscaloosa 8/12/2014: 11:30 AM - 5:00 PM: University Mall, 1701 McFarland Boulevard East #100

Walker
Jasper 8/9/2014: 12:00 PM - 5:00 PM: Jasper Mall, 300 Hwy 78 East

Washington
Chatom 8/5/2014: 11:30 AM - 3:30 PM: Washington County Health Department, 14900 Saint Stephens Avenue

Wilcox
Pine Hill 8/6/2014: 10:00 AM - 2:00 PM: City Hall, 50 Dunn Street

Winston
Haleyville 8/7/2014: 12:00 PM - 5:00 PM: City of Haleyville, 911 21st Street


How to donate blood
Simply call 1-800-RED CROSS (1-800-733-2767) or visit redcrossblood.org to make an appointment or for more information. All blood types are needed to ensure a reliable supply for patients. A blood donor card or driver’s license or two other forms of identification are required at check-in. Individuals who are 17 years of age (16 with parental consent in some states), weigh at least 110 pounds and are in generally good health may be eligible to donate blood. High school students and other donors 18 years of age and younger also have to meet certain height and weight requirements.


About the American Red Cross
The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation’s blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or visit us on Twitter at @RedCross

Sunglasses- more than a fashion statement

By : Adam Gordon, O.D., M.P.H. Clinical Associate Professor UAB School of Optometry


Most people know that sunscreen protects the skin from the damaging effects of sun exposure, such as premature aging and wrinkling, carcinomas, and potentially life-threatening malignant melanoma. However, most Americans are not aware of the damaging effects of excessive sun exposure on the eyes, nor are they aware that sunglasses serve as “sunscreen for the eyes.”


Just as sunscreen offers broad-spectrum protection to the skin, sunglasses should also block virtually all ultraviolet B (UVB) and ultraviolet A (UVA) radiation from entering the eyes. UVB is primarily absorbed by the external ocular surface and cornea, while the longer UVA rays can penetrate deeper, even reaching the crystalline lens and retina. Excessive sun exposure is associated with external ocular lesions such as pingueculae and pterygia, as well as basal and squamous cell carcinomas on the eyelids and periocular skin. Since the skin comprising the eyelids and surrounding area is relatively thin, it is very susceptible to sun damage such as loss of elasticity, wrinkling, and discoloration.


The cornea and crystalline lens of the eye are transparent, avascular, and immunologically unique. The deleterious effects of UV exposure on these structures are thought to be cumulative over decades. In childhood and adolescence, the crystalline lens is extremely transparent, allowing some UV radiation to reach the retina. Research suggests that up to 50% of our lifetime UV exposure occurs by age 18, suggesting that sunglasses are especially important during active childhood years.


Numerous large-scale epidemiological studies show a significant association between sun exposure and cataract formation. People with outdoor occupations or avocations may develop cataracts earlier in life that progress more rapidly compared to indoor workers. The regular use of sunglasses when outdoors may serve to decrease the risk of cataract formation in later life. The link between sun exposure and age-related macular degeneration is more tenuous than with cataract formation, but sunglasses may be an easy preventive measure to protect the retina from UV radiation.


Recent research in animal models suggests that short-wavelength blue light, also known as “high-energy visible” (HEV) light may be damaging to retinal cells and metabolic processes. The animals used in these studies developed retinal degeneration that may be similar to macular degeneration in humans. More research is needed before a definitive link to human retinal disease can be made, but there may be value in using sunglasses that block HEV rays in addition to UV radiation.


Here are some general tips about purchasing sunglasses:

• Sunglasses should have a label stating they block 100% of UVA and UVB rays (broad spectrum protection)

• The lenses should ideally be made of polycarbonate- a lightweight, impact-resistant plastic that provides excellent UV protection

• The lenses should fit as close to the eyes as possible, with a curved shape that wraps around the face to block light from the sides

• The lenses should be dark enough so that the wearer does not see, or barely sees, his or her eyes when looking in a mirror

• The most common sunglass lens colors are gray, green, and brown. Gray lenses have the least effect on color perception.

• The color of a lens and it’s darkness are not indicative of its ability to block UV rays

• Polarized sunglasses provide an additional glare-blocking benefit from water, sand, concrete, car bumpers and hoods, snow, and ice

• Good sunglasses providing 100% UV protection do not have to be expensive


A good web reference for consumers and health professionals is: http://www.allaboutvision.com/sunglasses/spf.htm#news2

Are We Losing the Battle with Diabetes?

By: Melanie Rubery MS RD


An alarming report was just released by the CDC citing 29.1 million Americans have diabetes. This is up from 26 million in 2010, roughly 1 million new cases each year. To add to this epidemic, around 86 million (1 in 3) have pre-diabetes. This means an individual’s blood sugar is higher than normal, but does not yet meet the criteria for a diabetes classification. Furthermore, many prediabetics are unaware they have it. This data resonated with Ann Albright, CDC’s director of Diabetes Translation, “These new numbers are alarming, and underscore the need for an increased focus on reducing the burden of diabetes in our country ” and “We simply can’t sustain this trajectory.”


If the current trends continue, federal health officials predict one in five Americans could have diabetes by 2025 - and one in three by 2050.


Diabetes exists in 2 categories-Type 1 and Type 2. Type 1 occurs as a result from an autoimmune illness and involves an inherited dysfunction of insulin-producing pancreas cells. However, according to the U.S. National Institutes of Health, 90-95% of diabetes cases fall in the Type 2 category. More importantly, type 2 diabetes is heavily influenced by weight. Americans continue to struggle with their weight as we now have 2 out of 3 adults overweight and 1 out of 3 classified as obese. The sooner people are aware they have prediabtes, the sooner they can take action and increase their chances of not developing type 2 diabetes.


Key sectors to address include children and minorities. Blacks, Hispanics, and American Indian/Alaska Native are about twice as likely to be diagnosed with diabetes as an adult. The surge in childhood obesity has also brought about an increase in pediatric diabetes. The CDC reported 208,000 children being diagnosed with either Type 1 or 2 from their 2012 health data.


The key to slowing down this progression involves lifestyle and behavioral change. Edward Gregg, chief of the CDC’s Epidemiology Division and Statistics Branch echoed this point “If we want to reduce the overall burden of diabetes in our nation, we have to focus on preventing diabetes in the first place.”


Americans are eating more processed and added sugars than ever before. Couple this with a less active lifestyle and waistlines expand. In my clinical practice, I see a combination of resistance to behavior change plus confusion with food labels and food choices. This makes it hard for lasting change as once someone gets to the point they are ready to make that change, they are limited in resources and education.


For diabetics and many other chronic diseases, counting calories is a small piece to the puzzle in health management. It’s the nutrition quality of those calories that makes the biggest impact. It’s very important for a diabetic and prediabetic to watch their carbohydrate intake, choose low glycemic foods, get adequate fiber, and stay within their daily added sugar recommendation. However, current food labels only mention total sugars and do not differentiate between natural and added sugars. One may think low-fat flavored Greek yogurt is okay, but if it is loaded with added sugars, a diabetic needs to take a second look. This is only one example with the confused consumer. The bottom line is that if making this lifestyle and behavior change is difficult, individuals will become frustrated and go back to their old eating habits.


Overall, the healthiest eating plan is to focus on fruits, vegetables, high-fiber/whole-grains, fish, lean meats, and anti-inflammatory foods. Having the support and expertise of a registered dietitian is key as we can individualize plans specific to a patients dietary and food preferences.


We also shouldn’t forget about physical activity. Multiple studies show you need a combination of both good nutrition and daily exercise to achieve a healthy lifestyle. A good rule of thumb is to aim for 30 minutes a day, 5 times each week.


What happens if diabetes is left untreated and why is intervention and prevention key? Diabetes boosts the risk of other complications such as heart disease, stroke, kidney disease, and premature death.


At the same time, the healthcare costs associated with treating diabetes is roughly $240 billion each year. This is up from $174 billion in 2010.


As diabetes rates continue to rise, so will the healthcare expenditure. Unless we can get a handle on early prevention and resources to better educate and support, we face a huge financial and human cost.



Melanie Rubery MS RD is a registered dietitian and CEO of a Birmingham mobile health app company, Nutripilot. Nutripilot aims to navigate individuals to healthier food choices based on specific medical conditions. To learn more, visit www.nutripilot.com