Download JohnsHopkins US SU11

Compliments
of Johns Hopkins
USA
summer 2011
Insight and news from Johns Hopkins Medicine
Putting
cataract
surgery in
focus
Guiding
your tween
daughter
Faster
recovery
from joint
replacement
Inside Obesity
Johns Hopkins experts seek new ways
for people to lose weight
Contents
S U M M E R 2 011
4| Clear Solution Qu ic k Con s u lt
Focus in on the cause of
cataracts and learn about
specialized eye surgery.
Find out what’s normal,
and what’s not, as your
daughter enters puberty.
1 0|A Heartbeat
First Pe rson
Gone Haywire James Cromwell conquered
sudden cardiac death,
thanks to fast-acting family
and emergency teams.
11|Is Your Life Out
S econ d Opi n ion
of Joint? Discover the secret for
quicker recovery after
joint replacement surgery.
ON THE COVER
War
6| Waging
on Weight
Johns Hopkins seeks
long-term solutions to the
complex problem of obesity.
Join Our Online
Communities
@HopkinsMedNews
YouTube.com/johnshopkinsmedicine
Search Johns Hopkins Medicine
Learn more
News and publications
Hopkinsmedicine.org/news
Clinical trials
Trials.johnshopkins.edu
ealth seminars
H
Hopkinsmedicine.org/healthseminars
2 | johns hopkins health
Summer Eczema
Management
F
5|Girl Talk |
Shedding Light on
summer 2011
or most people with eczema (atopic dermatitis), summer brings a respite from
skin sensitivity. For others, the season of sunshine and perspiration means
flare-ups. “Sunlight actually serves as a trigger to make their disease worse,”
says Ron Sweren, M.D., a dermatologist and director of the photomedicine
unit at Johns Hopkins. On top of that, some sunscreens aggravate the condition, he says. Look for skin-sensitive sunblock. “Good skin care is good skin care …
whether it’s winter or summer,” Sweren says.
Because people perspire more in summer, they may bathe more, and frequent washing, with or without harsh soap, can worsen eczema, adds Sewon Kang, M.D., director
of the Department of Dermatology. Adequate moisturizer is essential, he says. During any season,
phototherapy—the use of light to treat skin
disorders—may be an option for people who
have eczema with severe itching.
Johns Hopkins is one of a few
U.S. institutions to offer stand-up
UVA1 treatment. UVA1 rays offer
the skin-soothing benefits of sunlight, yet are less likely to cause
sunburn. Because the patient
is standing up, the entire body
can be treated at one time.
“This light source seems
to control itching quite well,”
Kang says, “and can also help
dissipate the rash of eczema.”
For more information, appointments or consultations, visit hopkins
medicine.org/dermatology.
Common-Sense Wound
Care Is Key to Healing
As usual, your mother was right. Prompt, careful cleaning of children’s skin
wounds may be more important than the use of antibiotics.
A new Johns Hopkins Children’s Center study looked at two anti­
biotics used to treat staph skin infections. According to the researchers,
95 percent of the children in the study recovered in a week, regardless
of the antibiotic they were prescribed.
“It seems that good, low-tech wound care, cleaning, draining and
keeping the infected area clean, is what truly makes the difference,” says study
lead investigator Aaron Chen, M.D., an emergency physician at Johns Hopkins.
For more information, appointments or consultations,
call 877-546-1872 or visit hopkinschildrens.org.
877-546-1872 | hopkinsmedicine.org/usa
healthinsights
Could Hearing Loss
Contribute to Dementia?
Older adults with hearing loss may be
missing out on more than just what’s being said. A study by
Johns Hopkins and the National Institute on Aging suggests
that hearing loss could increase the risk of dementia.
Researchers are trying to determine the reason. “That’s really
the billion-dollar question,” says study leader Frank R. Lin,
M.D., Ph.D., a Johns Hopkins otologist who specializes in
hearing loss among older adults.
Johns Hopkins is embarking on a long-term
study to search for a definitive link and to learn
whether treating hearing loss might delay the
onset of dementia. In the meantime, Lin encourages people to address signs of hearing loss.
“Hearing aids are essentially no-risk therapies,”
he explains, “and they clearly improve your quality
of life.”
For more information, appointments or
consultations, call 877-546-1872 or visit
hopkinsmedicine.org/hearing.
Watch and listen to Johns Hopkins hearing experts explain hearing loss and
treatment options. View “Can You Hear Me?” and “Hearing: Lost and Found”
at hopkinsmedicine.org/healthseminars.
Welcome,
All Children’s
Hospital!
Johns Hopkins Medicine recently
welcomed All Children’s Hospital as
a new member of the Johns Hopkins
Health System.
Located in St. Petersburg, Fla., All Children’s Hospital is a leader in pediatric treatment,
education, research and advocacy. It is a 259-bed free-standing pediatric hospital with outreach facilities in eight west-central Florida counties.
Drawing patients from throughout Florida, the U.S. and around the world, All Children’s
provides expert care in heart transplantation, blood and marrow transplantation, and pediatric trauma services, and is home to one of the largest neonatal intensive care programs
in the Southeastern U.S. As a regional referral center for children with some of the most
challenging medical problems, All Children’s, with its highly specialized staff, services and
facilities, can benefit even the most fragile pediatric patients.
Learn more about All Children’s Hospital at allkids.org.
hopkinsmedicine.org/usa | 877-546-1872
Sodium-Restricted
Diet Can Help
in Treating
Hypertension
Sodium intake is one of the leading drivers of high blood pressure
(hypertension). The main source
of sodium in Americans’ diets is
processed foods, especially baked
goods and cereals, such as bread,
breakfast cereals, muffins and
cakes. In fact, the average American
gets one-third of his or her daily
requirement by consuming those
types of foods.
Generally, reducing sodium in
the diet is a healthy choice for most
people. Ideally, you should try to
keep your intake under 1,500
milligrams per day. That is
quite low for the average
person, but it tells you
just what an important
role sodium plays in
cardiovascular health.
Always check your
food’s nutrition labels
for sodium content and
keep track throughout
the day of how much
you are consuming.
A good rule of thumb
is that individual food
products should contain no more than
200 mg per serving,
while meals should
contain less than
600 mg total.
Find more questions
answered by Johns Hopkins
Medicine experts and others
at sharecare.com, a new
Web site designed to simplify
your search for quality information on topics of health
and wellness.
summer 2011
johns hopkins health | 3
|
quickconsult
Clear
Solution
Get a good look at how to rid
yourself of cataracts—and the
need to wear glasses—from
Wilmer Eye Institute experts
Walter J. Stark, M.D., and
Oliver Schein, M.D., M.P.H.
What are cataracts?
Your eyes contain a lens that focuses incoming light rays.
A cataract is nothing more than your natural lens losing
its clarity as you get older. Symptoms include increasingly blurred or double vision, halos or blurriness around
lights, increased sensitivity to light and glare, the need
for frequent changes in eyeglass or contact lens prescriptions, and difficulty driving at night or in bright light.
How do I decide whether I
should have cataract surgery?
Choosing to have cataract surgery is a personal decision
based on your visual needs. At the Wilmer Eye Institute,
we ask patients: “Does your reduced vision interfere
with your activities of daily living?” The good news is,
the success rate here for cataract surgery is 99 percent.
How has technology improved?
When the eye lens is removed during cataract surgery it can be
replaced with a premium lens—called a multifocal intraocular lens
or an accommodating intraocular lens—that allows a patient to
focus near and far with a reduced need for corrective glasses. Eighty
to 90 percent of patients with the new premium intraocular lenses
can get through the day without wearing glasses. Even patients
with astigmatism can enjoy the benefits of clearer vision, thanks to
another kind of intraocular lens.
Are premium lenses right for me?
It depends. Premium lenses are not for people with other eye diseases, such as macular degeneration, severe glaucoma or diabetic
retinopathy. Also, the cost of premium lenses, which is not covered
by Medicare or major insurances, may not fit everyone’s budget. But,
according to one estimate, you could recoup that cost in 15 years by
pocketing the money you would have spent on glasses. n
Watch and listen to Johns Hopkins ophthalmologist Michael Boland, M.D., explain glaucoma and
cataracts. View “The Aging Eye” at hopkinsmedicine.org/healthseminars. For more information, appointments or consultations, call 877-546-1872 or visit hopkinsmedicine.org/wilmer.
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877-546-1872 | hopkinsmedicine.org/usa
Girl
Talk
Making puberty’s bumpy ride go
smoother for your tween daughter
H
oly hormones! You’ve seen
the signs—wispy hair peeks out
from under her freckled arms, her
slim, tomboyish hips form new
curves, and breasts begin to bud. Day by day,
your little girl’s body is transforming into a
young woman’s—and you just don’t know how
to handle it.
Relax. Johns Hopkins pediatric and adolescent
gynecologist Delese LaCour, M.D., reveals the
truth about tweens—their body angst, daunting
social pressures, monthly cycles and menstrual pain.
Here’s your guide on what to expect, including
what’s normal and what isn’t.
What to expect: Struggles with body image.
What’s normal: “It’s normal for tweens to
gain weight as they develop a more adult woman’s
shape,” LaCour says. “It’s concerning to them as
they develop hips and especially breasts. I hear lots
of concerns about breast development, especially
about asymmetry or size.”
What’s not: Your daughter uses negative
language to describe herself based on physical
development and attractiveness.
What to expect: Social pressures.
What’s normal: “It’s a time when a girl looks
for more acceptance outward, outside the
family,” LaCour says. “She’s trying to navigate
FREE
Online Seminar
Menstrual Problems
in Adolescents
self-acceptance and the idea that
she may be different from others
in her peer group.”
What’s not: Your daughter has
chest pains, trouble sleeping, tiredness or lack of energy. These are
symptoms of too much stress.
Thursday, October 6, 7–8 p.m.
Physical changes during puberty can be
difficult for teenage girls, particularly when
it comes to menstruation. Join pediatric
gynecologist Delese LaCour, M.D., as she
discusses the most common menstrual
problems adolescents encounter and the
best approaches for managing them. To
register, visit hopkinsmedicine.org/
healthseminars.
What to expect:
Menstrual cycles.
What’s normal: LaCour says it’s
normal for menstrual cycles to begin
within two years of breast development.
What’s not: Your daughter’s menstrual cycles
last longer than seven days, are spaced more than
90 days or fewer than 21 days apart, or are especially heavy (soaking one feminine hygiene product
every one to two hours).
What to expect: Menstrual cramps.
What’s normal: Mild cramping pain that can
be relieved with a heating pad or hot shower.
What’s not: Your daughter’s cramps stop her
from doing her daily activities or if she is absent
from school one or more days each month because
of pain.
For more information, appointments
or consultations, call 877-546-1872 or visit
hopkinsmedicine.org/jhcp. n
When It’s
Time to See a
Gynecologist
Your daughter’s first visit
to a gynecologist should
take place between ages
13 and 15, according to
recommendations by
the American College
of Obstetricians and
Gynecologists. But don’t
worry that she’ll need
a pelvic exam. Johns
Hopkins pediatric and
adolescent gynecologist
Delese LaCour, M.D.,
says most girls don’t
need one at that point.
Take an active role in your adolescent’s health. Johns Hopkins can help. Visit hopkinschildrens.org.
hopkinsmedicine.org/usa | 877-546-1872
summer 2011
johns hopkins health | 5
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Johns Hopkins exper ts
explore surgical and nonsurgical
solutions to the obesity upsurge
Johns Hopkins
offers a variety
of weight-loss
and management services.
To learn more,
visit hopkins
medicine.org/usa.
T
he Centers for
Disease Control and
Prevention reports that about
one in three adult Americans is obese,
a situation that’s exacting a huge toll
on society. Some 160,000 people die prematurely
every year because of obesity-related ills, according
to studies, and a person who is 70 pounds or more
overweight racks up as much as $30,000 in additional
lifetime medical costs.
A number of Johns Hopkins researchers have
been playing a crucial role in the effort to unravel
and tame this daunting, complex problem, and on
several fronts. This multipronged approach to tackling obesity has been paying off in key insights, as
well as in new treatments whose benefits and promise
are being proved in several groundbreaking studies.
For Tom Magnuson, M.D., the focus has been
on finding ways to make bariatric surgery an ever
more useful tool for combating obesity. Magnuson,
who heads the Johns Hopkins Center for Bariatric
Surgery, notes that bariatric surgery has far and
away been the most effective weight-loss tool for
those with a very high body mass index, or BMI—
a numerical scale based on height and weight in
which a number over 30 signifies obesity, and over
35 severe obesity.
“Most dietary and pharmacological interventions
don’t seem to result in the sort of dramatic, longterm weight loss that people who are 100 pounds or
more overweight need,” Magnuson says. “Surgery is
the only treatment method that results in durable
weight loss in that segment. It has potential risks,
but, for most people who carry that much extra
weight, the benefits are greater than the risks.”
Magnuson emphasizes that the primary goal of
the surgery isn’t weight loss, but rather improvement of the medical disorders that usually accompany extreme excess weight. He ticks off a grim
list: cardiovascular disease, type 2 diabetes, kidney
disease, sleep apnea, arthritis, increased risk of cancer, and more. But these problems are dramatically
improved and in many cases reversed after surgery.
“Eighty percent of people on diabetes medications
are off them within a month or two after surgery,”
Magnuson says. “Patients often come in here on
12 different medications, and six months after
the operation they’re already off 10 or 11 of them.
That’s gratifying.” He adds that it’s also an enormous
boon to a health care system that is staggering under
growing costs, noting that one large study showed
the resulting health care savings for bariatric surgery
patients exceeded the costs of the surgery within
two to three years after the operation. >
Weigh
Waging
War On
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ht
hopkinsmedicine.org/usa | 877-546-1872
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Long-Term Success Requires
Behavior Change
Is bariatric surgery
right for you? Visit
hopkinsbayview.
org for information about online
and in-person educational sessions.
As effective as bariatric surgery usually is, about one
in four patients who get the surgery never loses the
amount of weight expected, and most patients will
regain at least some weight. That vexing problem
is the one tackled by psychologist Janelle Coughlin,
Ph.D., who directs the Obesity Behavioral Medicine
Program at Johns Hopkins.
The essence of the problem isn’t related to a
defect in the surgery, Coughlin says. Rather, it’s
that while the surgical procedure prevents a patient
from taking in too many calories, that restriction
can be defeated if the patient doesn’t adapt his or
her eating habits. “People often have the surgery
without having fully engaged in lifestyle behavioral
changes,” Coughlin says. “And those changes are
necessary for success.”
The basic lifestyle changes that bariatric surgery
patients have to embrace, Coughlin explains, are
thought to be pretty much the same ones that
patients who want to lose weight the old-fashioned
way have to enlist: eating fewer calories (whether
from foods or beverages) and moving more. To
reduce the risk of postsurgical weight regain,
Coughlin meets with patients who are candidates
for the surgery to try to get a sense of whether
they’re likely to have particular trouble in adjusting
eating and exercise habits. In fact, insurance companies won’t cover the procedure unless the patient
has made some effort to lose weight nonsurgically,
but Coughlin tries to further zoom in on what
sort of approach the patient has taken.
“I’d rather see that they’ve learned to chew their
food more slowly and they’ve stopped skipping
breakfast than that they’ve lost several pounds,”
she says. “If they’re not making those sorts of
changes, then I worry that they’re waiting for surgery to fix all their problems, but it won’t.” That’s
why Coughlin favors working with patients on
lifestyle changes before surgery, instead of waiting
until weight regain becomes a problem months
after surgery.
Tangible Benefits of Support Groups
Is it possible to lose significant amounts of weight—
and keep it off—without surgery? The conventional
wisdom says no, at least for the great majority of
heavily overweight people. But Fred Brancati, M.D.,
is well on the way to helping overturn the conventional wisdom. Brancati, who heads the Division
of General Internal Medicine at Johns Hopkins, is
helping to run the largest, most ambitious clinical
trial of a nondrug, nonsurgery weight-loss intervention in history.
The trial focuses on helping patients change
their eating and exercise behaviors, with an eye to
rigorously proving that doing so provides the sorts
of impressive health benefits doctors have long been
saying would follow. “We know we’re supposed to
get improvements in heart disease, diabetes and
cancer risks when people lose weight with diet and
exercise,” Brancati says, “but no one has ever been
able to test that claim. This study will have a huge
influence on the way we think about and provide
care for obesity.”
Started in 2001, the ongoing study involves
5,000 overweight patients with type 2 diabetes.
(Recruitment is closed for this study.) Patients
were randomly assigned to get either the usual
care that people with diabetes receive, or participate in an intensive support program aimed at
changing the way they eat and exercise. This latter
group regularly meets individually with counselors, and attends frequent support group meetings
This isn’t a single battle. It’s a
long-term war, and we have to keep
the patients engaged in fighting it.
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and larger, themed events involving hundreds
of fellow patients—NASCAR, golfing and “beat
Pittsburgh” have been popular themes for the
Baltimore-area patients in the Johns Hopkins
patient group.
“We’ve been looking to create strong bonds
between the patients themselves and between
patients and counselors,” says Jeanne Clark, M.D.,
an obesity expert at Johns Hopkins and co-principal
investigator on the trial. “This isn’t a single battle.
It’s a long-term war, and we have to keep the
patients engaged in fighting it.” Although the study
continues through 2014, the results have already
been encouraging: After nearly a decade, patients
in the behavior-change group have kept their
weight 4 to 8 percent below the regular-diabetescare group. “It may not sound like a lot, but that
amount of weight loss can have a big effect on
disease risk,” Brancati says.
Interpersonal vs. Internet
It’s not necessarily losing weight that’s so hard,
notes Larry Appel, M.D., a colleague of Brancati’s
and director of Johns Hopkins’ Welch Center for
Prevention, Epidemiology and Clinical Research.
Rather, it’s keeping the weight off. And through a
parallel study to Brancati’s, Appel is pinpointing
what sort of behavior-change techniques work best.
In this second study, Appel has taken patients
who have lost at least 10 pounds and randomly
assigned them to one of three groups: a group
that gets no special support for weight-loss maintenance; a group that receives support over the
Internet; or a group that gets support from a personal counselor, mostly by phone. The Internet
group had early but transient benefit while the
group that received regular personal contacts had
sustained weight loss.
“There hasn’t been a huge amount of research
into weight maintenance in the period after weight
loss,” Appel says. “Person-to-person counseling
works. However, my instincts are that the combination of a person-to-person program supplemented
by the Web would be even more effective.”
And not just any counseling. “A counselor who
just provides information won’t help that much,”
Appel adds. “We’ve really needed to train our counselors to understand human behavior and motivate
people to develop the skills required to deal with a
dangerous food environment out there.”
Another challenge: The costs of providing every
overweight person with frequent personal counseling would be overwhelming. That’s why Appel is
hopkinsmedicine.org/usa | 877-546-1872
hopeful that the availability of Internet support, while
it can’t replace counseling, can help reduce its frequency
and duration and thus lower costs significantly.
In spite of the progress made by these researchers
on different aspects of the problem, no one claims that
the obesity fix is right around the corner. But, thanks to
this research, the toolbox is getting fuller. That means
more overweight patients can look forward to reducing
their exposure to a host of disorders and significantly
raising their quality of life. That’s an improvement
that will have a profound effect on not just the third
of the population that suffers from obesity, but for all
of society. n
Will There Be
a Weight-Loss
Pill?
Hope remains high that medical science will be able to provide a drug that
safely makes weight loss easier. To that end, Tim Moran, Ph.D., who directs the
Behavioral Neuroscience Lab at Johns Hopkins, has been studying “brain-gut
communication”—that is, the way the body releases chemicals in the gut that
help signal the brain that it’s time to stop eating.
Versions of these so-called satiety peptides work at different sites in the
body and in different ways, providing Moran and his colleagues with a number
of avenues for a potential intervention that would crank up the stop-eating
signals in obese patients. One big clue that leads Moran to think he may be
on the right track: The release of many of these peptides increases in patients
who have bariatric surgery, an increase that appears critical to these patients
feeling full after eating only small amounts of food.
“If we can make those sorts of signals more potent in patients who don’t
have surgery, we might see the same sort of results,” Moran says.
Not that coming up with a viable drug to strengthen the satiety signal will
be easy. A big part of the problem is that the body typically uses the chemicals
it produces for many tasks, and that’s probably true of satiety peptides as well.
That means increasing their strength may indeed lead to less appetite, but it
could also have undesirable side effects, especially in the brain.
One strategy for trying to get the satiety effect without risking much harm
is to come up with molecules that are very similar to the satiety peptides and
work well in the gut, but that are too big to make it into the brain, which filters
out many chemicals. In fact, Moran notes, researchers have discovered drugs
that operate this way and can lead to weight loss of as much as 20 percent
within six months. But so far they’ve only worked as injections, not as pills,
making them unlikely to catch on with doctors and patients. Moran is also
looking into how different types of bariatric surgery affect peptide levels.
“We’re hoping we can identify less drastic forms of surgery that will still
provide comparable feeding suppression and weight loss,” he says.
summer 2011
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firstperson
A Heartbeat
Gone
Haywire
Catheter
After an
irregular heart
rhythm struck
out of the
blue, James
Cromwell made
a dramatic
comeback
Understanding
Ablation
w
w
w
cardiac electro­
A
physiologist, using MRI
images and electrical
signals, pinpoints where
the irregular rhythm is
originating in the heart
and destroys (ablates)
a tiny bit of tissue to
prevent recurrence.
I never
expected my
he procedure has an
T
85 to 95 percent success
rate for idiopathic ventric­
ular tachycardia (without
structural heart disease).
F or patients with ischemic
ventricular tachycardia
(with structural heart
disease), the success rate
is 70 to 80 percent.
FREE
Online Seminar
Treatment Options
for Ventricular
Tachycardia
Tuesday, September 20, 7–8 p.m.
If you have ventricular tachycardia (VT),
you may be a candidate for VT ablation.
Join Johns Hopkins electrophysiologist
Saman Nazarian, M.D., as he discusses the
treatment options beyond an implantable
defibrillator. To register, visit
hopkinsmedicine.org/
healthseminars.
heart’s steady beat to
suddenly go haywire.
But an arrhythmia, or
irregular heart rhythm,
can strike out of the blue,
as it did one night in July
2009, just after my wife,
stepdaughter and I finished dinner at home
in Frederick, Md. As I got up from the table,
I collapsed, unconscious. My fast-thinking
stepdaughter performed CPR while my wife
dialed 911. Once the emergency medical ser­
vices arrived, they discovered my heart quivered
in a rapid chaotic rhythm called ventricular
fibrillation. My heart could no longer deliver
blood to my brain and muscles, a condition
called “sudden death.” The paramedics used
an external defibrillator to deliver an electric
shock through my chest, restoring my heart­
beat’s normal rhythm—for a while.
I was rushed to the ER, where my
heart erupted into the same chaotic
rhythm 10 times in 45 minutes,
requiring more shocks. I was even
given my last rites. After I was
stabilized, I was transferred to
Johns Hopkins, where they used a
cooling technique to save my brain
function. Then surgeons placed an
implantable cardioverter defibrillator
(ICD) in my chest. The ICD delivers electri­
cal shocks to the heart, restoring its rhythms,
whenever it detects ventricular tachycardia
or fibrillation. I also began taking an anti­
arrhythmic drug called amiodarone, but the
ICD still had to send electrical shocks to
restore my heart’s rhythm 46 times in four
months after I left the hospital. When the
device goes off, it’s like a horse’s kick to the
chest; I started having panic attacks over when
it might go off next.
Then, Dr. Saman Nazarian, a Johns Hopkins
cardiologist, told me about a minimally invasive
procedure called catheter ablation that’s used to
treat arrhythmias, and I agreed to try it. Using
an advanced technique, Nazarian pinpointed
the origin of my heart’s arrhythmias before he
cauterized the area to stop the irregular electri­
cal activity. The procedure was a huge success,
and I no longer live in fear of my ICD. My
heart’s steady, rhythmic beats are a gift from
Johns Hopkins’ talented doctors and medical
staff who saved my life. n
To watch a video of James Cromwell telling his story, visit hopkinsmedicine.org/mystory.
For more information, appointments or consultations, call 877-546-1872.
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secondopinion
Is
Your
Life
Out of Joint?
Rapid recovery program enhances
life after joint replacement surgery
T
he decision to have
joint replacement surgery
can seem nearly as agonizing
as those painful and aching
joints. But the good news
for bad hips and knees: Recovery from
joint replacement surgery is probably
much quicker than you think.
Johns Hopkins’ rapid recovery program for hip replacement puts healing
on a fast track, says orthopedic surgeon
Simon Mears, M.D., Ph.D. Whereas a
typical hospital stay after hip replacement can range from three to 10 days,
with this program, “you’re in the hospital
for a day or two,” Mears says, “and we’ll
get you up right away and moving so you
can go home and, ideally, start outpatient
therapy the next week.”
Afterward, you can return to work in
as early as two weeks, resume your daily
30-minute walks in four to six weeks
and get back on the golf course or play
other sports in two to three months,
Mears says.
The secret for this success? The first
step is for patients to meet with a physical therapist before surgery so they know
what to expect and to begin “prehabili­
tation.” Mears says building strength in
the muscles surrounding the damaged
joint will not only help patients regain
function more quickly but also will help
relieve pain and give them a good idea
of some of the exercises they will perform
after surgery. Procedures are usually
scheduled early in the day so patients can
stand up and walk the day of the surgery,
with nerve blocks providing pain relief.
“On the day after that,” Mears says,
“patients will do more therapy, climb
some stairs and hopefully go home.” n
Moving
Statistics
w
w
w
Musculoskeletal symptoms—
such as pain, aches, weakness and
limited movement—were the
No. 1 reason for physician visits in
2008, according to the latest data
from the American Academy of
Orthopaedic Surgeons.
With Americans living longer than
ever, the American Association of
Hip and Knee Surgeons estimates
there may be a need for 500,000
hip replacements and 3 million
knee replacements in the U.S.
each year by 2030.
About 90 to 95 percent of hip
and knee replace­ment patients
have good to excellent results,
even 10 years after surgery.
For more information, appointments or consultations, call 877-546-1872 or
visit hopkinsbayview.org/jointeffort.
hopkinsmedicine.org/usa | 877-546-1872
summer 2011
johns hopkins health | 11
|
Non Profit Org.
U.S. Postage
PAID
Johns Hopkins Health
Marketing and Communications
901 S. Bond St., Suite 550
Baltimore, MD 21231
In 2010, The Johns Hopkins Hospital was ranked for the
20th consecutive time as the No. 1 hospital in America by
U.S.News & World Report. hopkinsmedicine.org/usnews
We’re here for you
To find this issue online or
email it to a friend, visit
hopkinsmedicine.org/health/usa
For comments, requests or changes
of address:
NEW YORK
PHILADELPHIA
BALTIMORE
Email
[email protected]
Write
Johns Hopkins Health
c/o Marketing and Communications
901 S. Bond St., Suite 550
Baltimore, MD 21231
WASHINGTON, D.C.
Call
877-546-1872
W
e are pleased to offer you Johns Hopkins USA, a
convenient link to Johns Hopkins’ expertise—no matter
where you live. With one call, a caring, knowledgeable
coordinator will guide you through the best medical care in a way that
is tailored to your needs. And to ensure your trip to Baltimore is smooth
and comfortable, we’ll help you:
n S
chedule medical appointments with the right specialists
Make travel, lodging and transportation arrangements
n Know what to bring and what to expect
n
UNITED STATES
CANADA
To learn more or to request assistance, call
877-546-1872 or visit hopkinsmedicine.org/usa.
Kathy Smith
Director, Market Development
Steven J. Kravet, M.D.
Physician Adviser
Johns Hopkins Health is published quarterly by
the Marketing and Communications office of
Johns Hopkins Medicine. Information is intended
to educate our readers and is not a substitute
for consulting with a physician.
Designed by McMurry.