Your joints are involved in almost every activity you do. Simple movements such as walking, bending, and turning require the use of your hip and knee joints. Normally, all parts of these joints work together and the joint moves easily and without pain. But when the joint becomes diseased or injured, the resulting pain can severely limit your ability to move and work.
Whether you are considering a total joint replacement, or are just beginning to explore available treatments, we can help. It helps to understand the causes of joint pain and treatment options. Most importantly, learning will give you hope that you will be able to do more of the things you enjoy — with far less pain.
One of the most common causes of joint pain is arthritis. The most common types of arthritis are:
Osteoarthritis (OA)
It is sometimes called degenerative arthritis because it is a “wearing out” condition involving the breakdown of cartilage in the joints. When cartilage wears away, the bones rub against each other, causing pain and stiffness. OA usually occurs in people aged 50 years and older, and frequently in individuals with a family history of osteoarthritis.
Joint pain can also be caused by deformity or direct injury to the joint. In some cases, joint pain is made worse by the fact that a person will avoid using a painful joint, weakening the muscles and making the joint even more difficult to move.
The medical management of arthritis and joint degeneration may be handled by a family doctor, an internist or a rheumatologist. However, when medical management is not effective, an orthopaedic surgeon should be consulted to determine if surgery is an option. In some cases, the orthopaedic surgeon may be the first physician to see a patient and make the diagnosis of arthritis.
So if you are dreading the Spring and the gardening that comes along with it because of joint pain, give us a call! We want to help you get your life back! The NORTH Institute (985)871-4114, with locations in Lacombe, Hammond, Slidell, and Bogalusa.
Monday Morning, Manning’s Back will Know He Played the Saints! Thanks to Fujita, McCray, and the Boys…..
But you, on the other hand, Your Spine Deserves Special Care.
Your spine is at the center of a delicately balanced system that controls all of your body’s movements. Bones, muscles, ligaments, tendons, and nerves all work together to balance the weight of your body. Even minor damage to one component of your back’s structure can upset this fragile balance and make movement painful.
It is not surprising, then, that back pain is second only to headache as the most common cause of pain, or that 8 out of 10 people will have a problem with back pain at some time. The causes of back pain can be simple or complex; the vast majority can be treated nonsurgically, but in some serious cases, surgery is necessary. Physical Therapy and anti-inflammatory medications are most often tried initially, depending on the severity of the injury, or length of time the problem has been occurring.
And if you happen to throw yours out while cheering the Saints on…The NORTH institute can help! Our TEAM of specialists, including physicians and physical therapists, work together to create individualized plans for each client!
NORTH Institute (985)871-4114, with locations in Lacombe, Hammond, Bogalusa, and Slidell! We BACK the Black and Gold! Go Saints!
Sports in Louisiana are a very important part of our culture! Especially right now…need I mention the Saints are 12 and 0?? But seriously, whenever a player goes down on the field or court, and does not get up right away, you have to admit, your heart skips a beat, now doesn’t it? You read the news “Reggie Bush - knee injury, Scott Fujita - knee injury, Chris Paul - sprained ankle, Tracey Porter - knee injury, Lance Moore - Ankle injury, Heath Evans - out with torn ACL”, and the list goes on….when will the madness end? Well the good news for them is that they are on a TEAM! So thank goodness, some others can fill in, and also thank goodness, still do an AWESOME job! But for most of us, we don’t have that second string! So again, thank goodness for places like the NORTH Institute!
Injury to the ACL is one of the most common knee ligament injuries. Even though most ACL injuries occur during a sports activity, ACL injuries aren’t just caused by being tackled while playing football. Injury results when the ACL is stretched beyond its limit. You may have injured your ACL by pivoting quickly, landing poorly from a jump or by hyperextending your knee. So what are the symptoms of an ACL injury? You may have heard a popping sound when your injury first occurred. After that, severe pain and severe swelling of the entire knee probably sent you right to your doctor or emergency room. Other symptoms include an inability to move your knee normally, or walk without pain or a feeling of instability. In addition to examining your knee in specific positions and manipulating its movement, your doctor will likely want you to have X-rays (to check for fractures) or an MRI. Then…
Brace yourself! While you and your doctor determine the extent of your injury and the appropriate course of action, you may be given a knee brace for support and stability.
Get the right moves! Make sure your knee is stable during routine activities, and you refrain from participation in any high-risk sports and activities. Your doctor may recommend specific strengthening exercises to perform on your own throughout the day or refer you for a full course of physical therapy. Unlike muscles, ligaments don’t have their own blood supply and cannot heal themselves. If you are still experiencing pain after all other conservative measures have been taken, your doctor may suggest surgery to repair the tear, help relieve your pain and help restore your mobility.
Commit to feeling better. After surgery, you will likely be able to go home the same day. You may have to wear a splint or brace for a period of time while you heal and most people use crutches for the first few weeks. Full recovery from ACL repair may take up to a year. Therefore, causing you to be “out for the season”. Rehabilitative physical therapy will require six to nine months. Complete rehabilitation often depends on your commitment to following your doctor’s recovery recommendations. It is critical that you don’t return to full activity too soon.
The foot and ankle are two of the most versatile and complex areas of your body. One foot alone contains 26 bones supported by a network of muscles, tendons, and ligaments. When everything is working well, you hardly give them a thought. But when a problem arises, it’s often impossible to ignore. Millions of visits to physicians’ offices are made annually because of foot and ankle problems, including more than 2 million visits for ankle sprains and strains and more than 800,000 visits for ankle fractures.
Fortunately, most cases of foot and ankle pain respond well to treatments like rest, ice, orthotics (shoe inserts), prescribed exercises, and anti-inflammatory medications. Local cortisone injections can also provide pain relief. However, when these medical treatments fail to provide adequate pain relief, surgery may be an option. Often foot and ankle surgery is performed on an outpatient basis using minimally invasive techniques. These techniques may mean less pain and less risk, as well as a faster recovery time.
So don’t end up on the “Injured Reserve” list! Commit to feeling better, and get back to the life you deserve!
Call for an appointment in Lacombe, Hammond, or Slidell!
NORTH Institute (985)871-4114
I am posting this late and I apologize. Have been very busy as of late and just returned from vacation today.
Anyway, I chose to discuss the Total Knee Arthroplasty surgical procedure for this month. As previously stated I work at the NORTH Institute where we specialize in spine surgery, general orthopedics, and physical rehabilitation (post-operative and non-operative). The Total Knee Replacement procedure is one of the most common surgeries of this current era of health care. As we all know the life expectancy of the American population continues to rise. This fact combined with the knowledge that an unprecedented amount of American citizens from the “Baby Boom” era are just reaching senior citizen age means that the incidence of this surgical procedure will increase dramatically.
Why consider the Total Knee Arthroplasty (TKA)? The TKA is indicated for patients that have persistent knee pain secondary to severe or moderate degenerative joint disease. The procedure is specifically meant to decrease pain and increase functional mobility; therefore, increasing quality of life. Most of the patients that fall into this category are over the age of 65. Most have endured significant pain for a prolonged period of time with their activities of daily life. Most have had several rounds of intra-articular corticosteroid injections that initially helped with pain and swelling but no longer do the trick. Some have been through 1 or 2 series of Synvisc injections with a varying degree of success or failure. So to sum it up: we recommend TKA for patients that continue to have significant debilitating knne pain that no longer or never did respond to conservative treatment. There should be some evidence of degenerative joint changes.
What are degenerative changes? Is this Arthritis? Will everybody need this is they live past the age of 70? Degenerative joint changes can occur gradually over time as people age or they may occur in a relative short period of time secondary to some injury hat may have altered the bio-mechanics of the patients body. What we often see on Xray is a decreased joint space - either medially, laterally, or evenly throughout the joint; this is evidence that the cartilage in the joint has diminished. We also often see bone spurs (osteophytes) within and around the joint. Intra-operatively this excess bone is easily visualized; it is often rough (as opposed to a normal smooth cartilage surface) with a poor quality of bone. Sometimes there a pebbles or rocks of bone that we find in the joint. In summary, all of the above can be termed degenerative and can be linked in some way to osteoarthritis (NOT rheumatoid). Not everyone, no matter their age, will develop degenerative joint disease (DJD) to the degree that requires a TKA. However, it must be noted that there are many elderly people out there with significant DJD that do not complain of limiting pain.
Is the procedure safe? Is it effective? As previously stated this is a very common surgical procedure. It is relatively safe. People that have other co-morbid medical conditions (i.e. heart disease, diabetes, kidney failure, history of blood clots, etc…) are at an increased risk of complications. However, these patients will always have an increased risk of complications with any surgical procedure. The statistics demonstrate that this procedure is very effective in both decreasing pain and increasing functional mobility; hence why it is so popular. For a more detailed review about the possible risks and compications speak directly to your orthopedic surgeon.
Describe the procedure. How long does it take? How long will I be in the hospital? Will I be able to go home at the time of discharge? The procedure itself takes anywhere from 60-90 minutes unless there are intraoperative complications. Without getting too technical, the procedure consists of the orthopedic surgeon measuring and sawing off the distal end of the femur, the proximal end of the tibia, and the backside of the patella and replacing them with prosthetic components either metal or plastic. By doing this we re-create a smooth joint surface. In our practice we perform most of these procedures on a Tuesday and the patient either goes home or to a skilled nursing facility on that Friday depending on heir functional mobility status. Most of our patients receive femoral and sciatic nerve blocks just prior to the procedure; these can sometimes numb the majority of the involved leg eliminating a significant amount of post-op pain. However, they may also cause weakness in the leg. When the patient wakes up Tuesday after surgery, their pain should be minimal. If they experience pain there is acess to pain medications either by mouth or through their IV line; some patients may hae a PCA (patient controlled anesthesia - “push the button when it hurts”). A CPM (continuous passive motion) device is applied to the patient’s leg in the operating room; so they wake up with this contraption on their leg. The first day post-op is spent mostly in bed and at a bedside chair. The following morning (Thursday), the nerve blocks, the PCA, and the foley catheter (for urine) are removed. The patient will get out of bed and will walk using a rolling walker (in most cases); the patient can put as much weight on their operated leg as they can handle. Some patients do very well and are able to go home that evening but most patients go home on Friday morning. Patients that go home receive home health physical therapy 3-5 times a wk for 1-4wks as needed. A small percentage of patients struggle withpain and mobility issues and therefore, they are transferred to a skilled nursing facility where they have continuous care and receive physical therapy twice a day. If transferred to a skilled nursing facility, patients are required to stay there for at least 3wks. The 3wk thing is a fiancial issue. Medicare and most insurance companies require this in order to justify the transfer and therefore pay or reimburse the facility.
So there you have it. If contemplating this procedure Dr. Texada or myslef will be happy to discuss everthing in great detail in the office. It is the Tuesday morning after labor day and I am off the operating room. Our first case is a TKA.
Dr. Paul Worsham, DC of the Advanced Wellness Center in Mandeville, LA welcomes pain sufferers to the clinic for relief of neck pain, back pain, fibromyalgia, migraines, headaches, sciatica, carpal tunnel syndrome, spinal stenosis, bulging, herniated, ruptured, degenerated and degenerative spinal disc disease. Offering Spinal Disc Decompression, Spinal Physical Rehabilitation Therapy, Wellness Care, Chiropractic Care, nutrition and weight loss. Please call 985-867-8100 to schedule a free consultation or visit our website, Advanced Wellness Center, for more information about our revolutionary, non-invasive wellness programs.
It is the beginning of the month again and here I am. I have previously introduced myself on my first blog. I am a health care provider for The NORTH Institute. Within our practice we offer a variety of services; general orthopedics, rehabilitative medicine, physical therapy, brain surgery, and spine surgery are our most prominent services. As a physician assistant in our practice I have the privilege of working with all of our physicians within each of their specialties. I often work in the spine clinic where I am able to evaluate and treat many patients with neck and low back injuries. Statistics show us that neck and low back problems are very common among the general population. In fact 9 out of 10 people will have a low back problem at some time in their life. There are a variety of causes for neck and low back problems ranging from work injuries and motor vehicle accidents to age-related wear and tear. Our treatment options range from conservative treatment such as physical therapy, medications, and epidural injections to surgical intervention.
At The NORTH Institute we are innovative leaders in the field of cervical and lumbar surgery. We perform around one hundred neck surgeries per year. The majority of the cervical surgeries that we perform are done with the purpose of reducing unmanageable neck pain, upper back pain, and/or arm pain, numbness, or weakness. Cervical spine injuries or degenerative changes often can lead to so-called axial pain (spine pain), referred pain (upper back pain), radicular pain and/or numbness (arm pain), or upper extremity myelopathy (arm and/or hand weakness). These symptoms may be the result of many cervical anatomic pathologic changes. Some of the most successful surgeries that we perform are the anterior cervical discectomy and fusion and the anterior cervical disc replacement.
The anterior cervical discectomy and fusion is tried and true and has a success rate in our practice that is greater than 90%. Most patients feel a significant reduction in the neck pain and over 80% experience a reduction in their arm symptoms. This surgery is most successful if one cervical level is addressed, however, the success rate for multi-level surgeries is excellent as well. With this procedure the surgeon approaches the spine from the front of the patient’s neck. The incision is usually made along a natural fold in the skin. The soft tissues and local nerves are carefully retracted and moved aside. The offending disc or discs are carefully removed from between the adjacent vertebral bodies. The space between the vertebral bodies is measured and an appropriate sized “cage” is placed between the vertebral bodies. Any bone that was removed is used as bone raft and is placed within the cage. Sometimes bone marrow from the hip is used as graft material and sometimes we use synthetic bone or cadaver bone. Once this is done we often place a titanium plate on the front of the spine and it is screwed to the vertebral bodies above and below the fusion level. he soft tissue and the skin are closed. The outer skin does not have sutures but instead is closed with superglue to leave less of a scar; plastic surgeons often use this technique.
If the surgeon feels that the cervical disc repacement is the most apropriate option the procedure is very similar. Once the spine is exposed and the disc removed, the spcae between the vertebral bodies is measured for an appropriate sized disc replacement prosthesis. This is then placed between the two bone. There is no anterior plate applied.
Patients that have undergone either of these procedures are able to get out of bed and walk later that day. Their post-op pain is usually minimal. They may have a mild sore throat or mild hoarseness. The very next morning they are usually discharged home. We have an extensive post-op follow schedule. We follow our patients post-operatively at 2wks, 4wks, and 6wks. Formal out-patient physical therapy is begun at 6wks post-op. Most patients have returned to their normal activities without any restriction at 12 wks post-operatively.
There are advantages and disadvantages to why the surgeon would recommend a cervical fusion versus a discectomy. These are based on an individual’s particular age, anatomy, pathology, and symptoms. Myself and the spine surgeons would be happy to discuss the details of cervical spine surgery with anybody that is interested.
I know you are thinking what does a Physician Assistant that works at the NORTH Institute know about laparoscopic hysterectomies. No the physicians at the NORTH Institute do NOT perform this procedure. However, I happen to have some inside knowledge about this procedure from a patient or patient family point of view. My lovely wife Shannon had a laparoscopic hysterectomy done last Thursday (5 days ago). The procedure was performed by her Gynecologist and lasted approximately 60-75 minutes long. Three small incisions were made on her abdomen; one on the right, one on the left, and one at the belly button. The entire procedure was performed with a scope and there were little to no complications. Shannon stayed overnight at the hospital and we went home later the next evening.
Being a health care professional and experienced with surgery my initial reaction was that the laparoscopic procedure is minimally invasive and my wife should be in much less pain and she should be able to be back to her normal self in no time. However, this is not necessarily true. Regardless of whether the hysterectomy is laparoscopic or open apart of the women’s body is removed. Intra-abdominal trauma has taken place and this takes time to recover from. Her functional mobility level is still affected for quite some time. My wife has spent most of the past 5 days in bed; getting up only to use the bathroom, shower, and eat. I was also unaware that most of my wife’s post-operative pain would not be at the operative site but instead is in her neck, under her shoulder blades and under her ribs. Apparently a significant amount of gas is pumped into the patient’s belly during the procedure. This is done to create a space for which to be able to see inside the body and to be able to maneuver and use the laparoscopic instruments. Most of this gas is suctioned out at the end of the procedure. However, some gas remains and it diffuses into the surrounding muscles of the abdominal and thoracic cavity. This gas within the muscles causes a significant amount of pain. Unfortunately my wife has been dealing with this. At this point 5 days post-operative this “gas pain” is starting to improve. However, since the surgery my wife has been using narcotic pain medications as prescribed for her post-op pain and this has led to another source of uncomfortabness; constipation.
I know that I am making this whole experience sound painful and surgery is usually not a pleasant experience. However, if a hysterectomy is recommended and it can be done laparoscopically it is considered beneficial for the patient. I am no gynecologist and I do not work for one. However, through my reading I understand that the risk of complications is greatly reduced, there is a much less soft tissues damage, and scarring is significantly decreased as well.
Again this blog has nothing to do with the NORTH Institute. This is just a excerpt from my personal experience. I plan on discussing current neck problems and up to date treatment options next week.
I know it is not quite the beginning of the month yet but I am posting this blog early because I will soon be going out of town with the LA Army National Guard. I believe in a previous post I had mentioned that I have been in the LA Army National Guard and the Regular Army combined for almost 18 years. I have been deployed to Iraq once in the past and I am scheduled to return in March 2010. My unit and I will go back on active duty in January 2010; we will train for about 3months prior to landing in Iraq at the end of March 2010. I plan to restart this blog when I reach Iraq. Believe it or not, it will be easier to get Internet connectivity in Iraq then it is in some of the places I will be training. Anyway, I leave tomorrow for 3 weeks of training focused on my upcoming deployment. I will NOT be able to post while at Camp Shelby, MS.
Anyway, onto the subject at hand. We have seen a rash of recent ACL (anterior cruciate ligament) injuries in the past 6 weeks. Dr. Texada and myself have done 6 ACL repairs in that time frame and we are scheduled to start one in the OR this morning.
The ACL of the knee runs from the front of the Tibia (lower bone of the knee) to the back of the Femur (upper bone of the knee). It crosses the PCL (posterior cruciate ligament); hence they are both named cruciate ligaments. The purpose of the ACL is to maintain anterior stability of the knee. The ACL is most commonly injured during some type of running activity. The ACL is torn or ruptured (either partially or completely) with a twisting motion of the knee or when the Tibia is forcibly translated forward on the Femur beyond the capacity of the ligament to hold it in place. That sounds a bit technical. What commonly happens is the guy playing flag football at the local recreation department catches a pass and turns to run when all of the sudden he feels a pop in the knee. The knee is painful and becomes swollen with significant bruising within the hour; it is hard to walk on the knee. The guy eventually makes his way to see the orthopedic surgeon either directly or through the Emergency department, or through his PCM. Once he gets to us based on his story and our physical exam we can make the diagnosis pretty easily. His physical exam will usually demonstrate a positive Lachman’s and anterior draw test; these are medical examination techniques that measure the competency of the ACL. Sometimes we order an MRI of the knee for good measure, but this is not always needed. Most of the time surgical reconstruction is recommended.
First of all I need to state it is called ” The Art of Medicine” for a reason. What I mean by this is that there is more than 1 way to surgically repair a torn ACL. A particular surgeon has a technique that he or she prefers for one reason or another. Some surgeons prefer to use an auto-graft (meaning a tendinous graft taken from the patient themselves) and some prefer to use an allograft (a cadaver tendon). There are positive and negatives to both approaches. If a cadaver tendon is used there are a variety of tendons to choose from. Basically the Orthopedic surgeon chooses the procedure that he believes is most beneficial to the patient; his belief is based on his or her training, updated studies that have been published, and most importantly his personal experience.
Dr. Texada prefers to use a semimembranosus and gracilis (hamstring) autograft. He prefers the autograft because first of all it is already a part of the patient’s own body and the risk of rejection and infection are minimal. Also the autograft is living tissue being harvested and implanted during the same procedure; this increases healing potential. Anyway, I was going to describe the procedure. I got started an then I realized that it is really alot of technical and medical jargon. Therefore, I’m not gonna do it. If anybody wants more detail then I will be happy to email it to them. There are many videos of the surgery that can be found on Youtube. 95% of ACL repair patients do very well with no complications and the ability to return to previous activity.
One other thing. I have been getting some comments but they seem like just spam to me. If I deleted your comment I am sorry. If there are any comments of questions I would be happy to address them. I’ll be back at the end of the month. I have made a promise to myself that I will start blogging at least twice a month and up to once a week.
Hi this is Mike again. The last time I was here I kinda just tried to introduce myself. I also tried to answer a very common question that I run across almost every day at The NORTH Institute; the difference between Physician Assistants and Nurse Practitioners.
Today I would like to introduce The NORTH Institute. We are located in Lacombe, LA . Right off of the I-12 HWY 434 exit and practically next door to the Louisiana Medical Center and Heart Hospital. Our clinic offers complete neurologic and orthopedic surgical and rehabilitative services. Many of you reading this are wandering just what that means. Well to start off with, there are 6 physicians in our practice. We have 2 neurosurgeons, an orthopedic spine specialist, a general orthopedic surgeon with a fellowship in Sports Medicine, and 2 Physical Medicine and Rehabilitaion specialist physicians, we have our own Physical Therapy department and gym, and we have a procedure room with flouroscopy in the office for smaller procedures like epidural steroid injections. We also have 3 “mid-level” practitioners; that’s another term for physician assistant or nurse practitioner. This includes myself, Arrias Brunet NP, and Lenzy Fisher NP.
Dr. Dietze and Dr. Weems are our neurosurgeons. They see a variety of patients in clinic and offer conservative as well as surgical treatments for almost any type of neurological lesion or pathology. The majority of the patients that they treat have some type of spine injury or pain. This includes cervical, thoracic, and lumbar problems or injuries. However, they also evaluate and treat for peripheral nerve injuries and central nervous system pathology such as brain tumors. Surgical services may vary from a simple nerve release to a lumbar fusion or disc replacement, to the removal of a brain tumor. These services are not unlike what most neurosurgeons offer. However, we do boast that our neurosurgeons are among the leaders in the Southeast Louisiana region. Along with Dr. Logan, they are performing the most technologically advanced and least invasive spine procedures that are available today. Some of the newest procedures have very high rates of success in long-term studies.
Dr. Logan has been practicing in St. Tammany parish for over 10 years. He is an orthopedic spine specialist and currently has dedicated his practice to only this population of patients. Again, just as Dr. Dietze and Dr. Weems he is educated in and certified to perform spine procedures that many other spine surgeons in our region have no experience with.
That being said, I don’t want you to think that every patient with back or neck pain that walks through the door is scheduled for surgery. That is NOT AT ALL how it works. In fact most patients get better without surgery; statistically, in our practice, only 1 in 10 spine patients are ever recommended for surgical procedures. Our practice is conservative in nature, and we only offer surgery when all conservative treatment options have failed or if it is felt that the patient may have a neurological risk. As a Physician Assistant I work with all three of these guys in the clinic and sometimes I get to assist them in surgery.
Dr. Texada is a general orthopedic surgeon with a fellowship in Sports Medicine. He sees a variety of patients in clinic. Treatments again range from conservative to surgical. I work with Dr. Texada in both the clinic and I am his usual “first assistant” in the operating room. In a typical month we perform many surgical procedures. Typical procedures include total joint replacements, fracture fixation, ACL repair, knee and shoulder scopes, rotator cuff repairs, carpal tunnel releases, and trigger finger releases (just to name a few). Again even though Dr. Texada is a surgeon, not every patient is headed to the operating room. There are other nonsurgical treatments available for most orthopedic issues.
Dr. Bryant and Dr. Braxton are both PM&R (Physical Medicine and Rehabilitation) physicians. They specialize in the nonsurgical treatment of musculoskeletal injuries and pain. They offer a variety of treatments and also perform epidural steroid injections. Dr. Bryant is an expert in electrophysiology and performs EMG/NCV studies at our clinic.
In our physical therapy department we have 2 fulltime Physical Therapists (Gage and Laurie Banks) and a PTA (Physical Therapist Assistant). Dave the PTA is also a Certified Athletic Trainer and has been working with High School athletes for a large portion of his career. The PT department is where treatment starts for most patients with neurological, musculoskeletal, or orthopedic injuries or ailments. So we keep them pretty busy. The PT department is also a great assest for post surgical out-patient rehabilitation. Being that they are in the same building as the physicians, communication with them concerning our patients is almost effortless.
So ther you have it. I hope that it doesn’t sound like a big advertisement for “my clinic.” Although I often refer to The NORTH Institute as my cllinic or our clinic, by no means am I in any way involved in ownership. I just feel that I am a part of it and it is a part of me. I guess it can be considered a term of endearment. On most days The NORTH Institute is a great place to work. We have a great staff (this includes the medical assistants, nurses, and office personnel) and great, leading edge physicians. Everybody there genuinely cares about our patients and we work hard to help them recover from whatever problems they may be facing. If you happen to need our services for anything, you may ask for “Mike” and I would be happy to see you.
It has been a month since my last blog entry. I am going to try a post a blog at least every couple of weeks or so. I would be happy to touch on anything that you may be interested in and that I am knowledgable about.
Hello, my name is Mike Beninato. I am a Physician Assistant at The NORTH Institute. Since this is my first time blogging, I’d like to introduce myself and share a little about my background.
I started out as a Physical Therapy Technician at Touro Infirmary while I attained my undergraduate degree in Psychology from UNO. Then I attended Delgado Community College and attained an Associates degree as a Physical Therapy Assistant in 1998. I worked in a variety of settings including acute care, skilled, brain injury, rehab, outpatient sports medicine, and home health.
As a member of the Louisiana Army National Guard (LAARNG) I applied to and was accepted into the Interservice Physician Assistant Program (IPAP). The origins of Physician Assistants are based in the US Army and Air Force. IPAP is one of the leading PA schools in the country. It is a very intense 26 month program that consists of 13 months of didactic study and 13 months of clinical rotations (residency). I left my wife and kids for these 2 years so that I could complete the program. We were able to see each other on occasion; this was probably the hardest part of the program for me. I graduated in 2004 and started working at The NORTH Institute.
In February 2005, I was notified that I was to be deployed to Iraq with my unit from the LAARNG; in fact the 256BDE was already in Iraq and I was heading there to relieve another Physician Assistant that was being sent home for hardship reasons. By the time I went through all the appropriate training I landed on the ground in Iraq April 1, 2005.
For most of my time there I was located with a relatively small group of soldiers; however, I was the only healthcare provider there. My unit and I returned home just after Hurricane Katrina, and so after a month of being a nomad my family and I settled back home in Covington and I returned to work at The NORTH Institute.
By the way I have been married for almost 8 years. I have 2 step daughters (15 and 13) and 2 smaller children (6 and 4).
Anyway, I guess I will address a very common question that I still get. What is a Physician Assistant and how is that different from a Nurse Practitioner?
Physician Assistant programs are Master’s level education and clinical programs that are accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). TheAmerican Academy of Family Physicians, the American Academy of Pediatrics, the American Academy of Physician Assistants, the American College of Physicians, the American College of Surgeons, the American Medical Association, and the Physician Assistant Education Association all cooperate with the ARC-PA as collaborating organizations to establish, maintain, and promote appropriate standards of quality for entry level education of physician assistants (PAs) and to provide recognition for educational programs that meet the minimum requirements outlined in these Standards.
To be a PA one must graduate from an accredited program and then pass the Physician Assistant National Certification Examination (NCCPA certification); this is like taking medical boards. Then one must apply for a license in their particular state. In Louisiana I am licensed by the Louisiana State Board of Medical Examiners just like Physicians. As a Physician Assistant I must work for and under the guidance of a Physician or Physicians.
To maintain my NCCPA certification I must participate in 100 hours of continuing medical education every 2 years and I must retake a re-certification exam every 6 years. As a PA I can do many things that most doctors can. However I must stay within the parameters of my supervising physicians’ comfort and confidence.
I am also trained to and am allowed to participate in surgical procedures. Some procedures that can be done in the office, I can do without “direct” supervision. With other larger procedures that are done in the operating room and under general anesthesia I am often the “first assistant.”
I am different than a Nurse Practitioner in many ways however, we also function in many similar ways as well. I have been taught that our education is different. NPs are educated by nurses from a nursing perspective which often times focuses on treating a patient according to their symptoms.
PAs are educated by physicians from the medicine model which focuses on determining the cause or etiology of a patients symptoms and then treating the patient appropriately. I know that these statements will probably cause some friction between myself and NPs that read this. However, my disclaimer is that this is what I was taught by the medical director of my program. In all practicality PAs and NPs do alot of the same things. We see and treat patients in the clinic and in the hospital. I also assist in alot of surgery. NPs are not trained to do this and therefore cannot do so unless they complete specialty training. Also, NPs are allowed to have their own practice where as PAs are not allowed to by LA state law.
Anyway, all this information is kind of boring and I apologize for the lengthy introduction. I will be happy to answer any questions about anything health related that is within my scope of practice. If I don’t know then I will be honest and tell you that and hopefully I can point you in the right direction so that you may get the information you are looking for. Next time I post I will try to introduce The NORTH Institute and what we do there.
