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Operation Walk Pittsburgh completes fifth successful mission trip

Carlos thought he would live in pain for the rest of his life. The high cost of knee replacement surgery in Honduras prevented him from being the mobile, active father he so desperately wanted to be.

Now, that’s all changed.

Operation Walk Pittsburgh’s 60-member volunteer team, including surgeons and staff from Tri Rivers Surgical, provided hip and knee replacements for poverty-stricken patients in San Pedro Sula — completely free of charge. Carlos, 32, was among those.

“I can’t wait to play soccer with my 6-year-old son, Cristopher,” Carlos said. “I am so grateful that you have come and given me this opportunity.”

Tri Rivers orthopedic surgeons Michael W. Weiss, M.D., and Thomas S. Muzzonigro, M.D., as well as physicians’ assistants Duane Chess and Chris VanSchepen and registered nurse Kate Jardine, traveled to San Pedro Sula, Honduras, for the second consecutive year to operate on patients and give them the gift of mobility.

In just the three days dedicated to surgery, the Operation Walk Pittsburgh team performed 59 joint replacements on 53 patients, nearly matching the yearly total for surgeries in Honduras. Typically, only 60 surgeries per year are performed in the country because of their high cost.

With so many residents requiring surgeries to maintain a healthier living, the experience is as sobering as it is rewarding. But the team takes the challenge head-on, providing the best care it can in the few days it is in town.

From 2009 to 2012, team members from Operation Walk Pittsburgh, which also provides free surgeries annually in Pittsburgh and Butler, had performed 242 free surgeries on 195 patients in Guatemala, Honduras and Panama.

And this year’s trip only continued to enhance those numbers. In San Pedro Sula, the second-largest Honduran city after the capital, Tegucigalpa, Operation Walk Pittsburgh’s efforts are deeply cherished.

“We feel strongly that walking is a key to life,” Dr. Muzzonigro said. “Walking is life. As far as what I’ve been able to do in my career, these experiences top everything.”

Click here for video of KDKA’s story on Dr. Muzzonigro and his son, TJ, talking about the mission trip

Though the doctors come in with their team and technology to perform the surgeries, after their departure, it becomes the responsibility of the hospital staff and residents in San Pedro Sula to ensure patients receive proper care on their road to recovery.

“They really are the driving force behind the success of this mission,” Dr. Weiss said. “They bring the process full circle and help the patients get back to their normal lives. This is a very rewarding experience. The amount of love we feel from people we don’t even know and can barely communicate with is astonishing.”

While the primary goal of the trip is to help provide mobility to residents, the team also recognizes their patients are not the only ones living in undesirable conditions. Children are no strangers to the tough times brought on by a weak economy in one of the poorest countries in the world.

On the second day of surgeries, some non-clinical volunteers from the Operation Walk team visited La Casa de Ninas orphanage, providing young girls with fun clothing and fashion accessories and playing soccer and card games together.

These same volunteers later visited Hagar San Rafael, a boys’ orphanage located on a nearby farm, where 40 boys ages 6 to 18 work each day. The team brought balls to play games, including an American football, which the children never had seen before. Team members took the kids to a pizza party to cap the day of entertainment.

The medical team then spent its last day at the hospital helping patients get acquainted with their physical therapy regimens and prepare for their new lives with increased mobility and decreased pain.

“I need you to tell every person what this means to me,” a patient, Maria, told the team before being discharged from the hospital. “You gave me back my hope, my ability to live life normally and without pain. Thank you from the bottom of my heart.”

To view photos from the trip, visit Operation Walk Pittsburgh’s website.

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Tips and tricks to help you stay vibrant

Think physical exercise is the only thing that can make you healthy? Think again.

Physical exercise, mental stimulation, stress reduction and diet all are vital to staying healthy and vibrant as you grow older.

Tri Rivers Surgical physical medicine and rehabilitation specialist Anna K. Gaines, M.D., discussed how to stay vibrant as we age recently at St. Barnabas retirement community in Gibsonia. And just how much we can control might surprise you.

Mobility and brain function are among the most important factors for healthy aging. Dr. Gaines said exercise is the key to preserving mobility, but exercise serves a greater overall health purpose. Higher lifetime exercise levels correlate with lower risk of heart and lung disease, chronic pain and brain disorders such as Alzheimer’s or Parkinson’s disease.

“Hundreds of millions of dollars a year go into research on exercise,” Dr. Gaines said. “Exercise in aging is studied a lot. It’s so powerful that researchers commit that much funding to it on an annual basis so we can keep building our knowledge.”

Exercise can improve physical strength and balance, increase your ability to perform daily tasks, improve chronic health conditions, reduce depression and improve brain function.

Dr. Gaines said people of all ages should exercise for 150 minutes per week, whether that is five times per week for 30 minutes or 10 sessions of 15 minutes each. Simply “being active” is not sufficient exercise.

She recommended finding ways to integrate exercise into regular daily activities. For example, walking with friends for 15 minutes after breakfast or lunch or doing 10 minutes of balance training while your coffee brews might afford reasonable opportunities for regular exercise. A complete exercise program includes aerobic activity, strengthening, flexibility and balance training.

Like the body requires a variety of exercise for maximum benefit, part of keeping the brain healthy and expanding it means breaking monotony. Your brain only gets exercised as much as it is challenged. If you find that you are breezing through puzzles or reading similar things on a daily basis, it might be time to challenge yourself by mixing up your selection.

Finding enjoyable activities to do can help counteract another condition that affects brain size and function: stress.

“Stress is a hard thing to treat,” Dr. Gaines said. “We don’t have any medications that take stress away. We don’t have an anti-stress button. But it doesn’t mean we can’t tackle it just because it’s hard. Sometimes, you need specific therapy to help work on stress and lower the impact of it.”

It is vital to address stress because it is a big enough factor to brain function that it can counteract all of the good things you are otherwise doing for your brain and body, Dr. Gaines said.

And among those good things you can do for your brain is maintaining good nutrition.

Dr. Gaines said the traditional Mediterranean Diet probably is among the most balanced and well-studied diets shown to positively affect cognitive health and body health.

People who maintained a high adherence to the Mediterranean Diet had a 28 percent reduction in the risk of mild cognitive impairment, according to a recent study. The positive effect on heart health and cancer risk is also well-documented.

This diet consists primarily of plant-based food such as fruits and vegetables, beans, whole grains and nuts. It replaces butter with healthy fats such as olive oil and replaces salt with flavorful herbs. It limits the consumption of red meat to a few times per month and suggests two servings of fish or poultry per week.

“With all of the choices we can make in our daily life, we most certainly have the capacity to influence our brain and body health as we age,” Dr. Gaines said. “The idea of staying vibrant as we age is something we can and should set as a goal.”

To request an appointment, click here or call 1-866-874-7483.

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Foot and ankle specialist helps seniors put best foot forward

Considering that the average person walks about 100,000 miles during his or her lifetime, it makes sense that many people experience foot problems by the time they reach their golden years.

Tri Rivers orthopedic foot and ankle specialist William E. Saar, D.O., discussed the diagnosis and treatment of common foot problems - including plantar fasciitis, progressive flatfoot deformity, bunions, hammertoe and Morton’s neuroma - during a recent presentation at St. Barnabas Retirement Communities.

One of the most common foot ailments is plantar fasciitis, an inflammation of the tissue that connects the heel bone to the base of the toes, according to Dr. Saar.

“A common sign of this condition is pain in the heel that occurs when a person stands after being in a sitting or lying position, especially first thing in the morning,” he said. “The patient may feel a sharp, stabbing pain in the bottom of the heel.”

Nonsurgical treatments include stretching exercises, rest, ice on the heel, activity modification, splints, heel cups or orthotics, steroid injections, casts and physical therapy.

About 90 percent of plantar fasciitis patients should improve after six to eight weeks using the conservative measures and without surgery, Dr. Saar noted.

Progressive flatfoot deformity mostly affects women older than 50 and those who are obese or have high blood pressure or inflammatory conditions. Signs can include pain and swelling of the ankle, inability to stand on toes and progressive loss of the arch.

“Without treatment, progressive flatfoot can develop into advanced arthritis of the foot and ankle,” he said. “The deformity can become so severe that ulcers may develop and predispose to infections, which may require aggressive surgical procedures.”

The patient can be treated initially with medication, rest, braces and, if necessary, surgery.

Another common condition encountered, particularly in women, is Hallux Valgus (commonly referred to as bunions).

“A bunion is a deformity at the joint that connects the big toe to the foot, which often appears as a swollen or sore bump,” Dr. Saar explained.

About 90 percent of bunions occur on women and are usually caused by improperly fitting shoes.

Dr. Saar suggests:

• Avoid sharply pointed shoes and heels higher than 2 1/4 inches

• Stretch shoes to ensure a better fit

• Use protective pads and splints if necessary to improve fit

Another common condition, the hammertoe deformity usually affects the second, third and fourth toes.

“The ailment occurs when a toe is bent resembling a hammer,” Dr. Saar explained. “It is usually related to improperly fitted (tight) shoes.”

Conservative treatment options include: toe splints, stretching exercises and good, supportive, well-fitted shoes. If these fail, surgical intervention may become necessary.

Morton’s neuroma occurs when the nerve tissue thickens as it passes under a ligament leading to the toes.

“It can cause burning pain in the ball of the foot that radiates into the toes,” Dr. Saar explained. “The toes involved feel numb, and symptoms usually worsens with activity or wearing shoes.”

About 80 percent of patients get relief with conservative treatments such as medications, shoe modifications and steroid injections.

Most people can avoid problems with their feet by wearing properly fitting shoes and taking conservative steps to address these conditions from becoming more serious health concerns.

To request an appointment, click here or call 1-866-874-7483.

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The woman in the mirror is pain free from arthritis

More than a decade ago, Janet Tempalski, now 63, of Cranberry Township, slowly walked toward the door of a local department store.

She saw a reflection of a woman in the store window and thought, “Who is the lady with bowed legs?” She quickly realized the reflection was hers.

Janet was among the 46 million Americans suffering from arthritis.

She didn’t want to have surgery because it would interrupt her life. So she lived with knee discomfort for more than 10 years. She had trouble with everyday activities, such as climbing stairs and working in the garden.

Finally, she decided to take steps to end the pain. Janet had two knee replacements, performed by William Abraham, M.D., a joint replacement specialist with Tri Rivers Surgical Associates.

In June 2011, Janet had her right knee replaced. Four months later, she had her left knee replaced.

Now, she plays with her grandchild and dog, and gardens without pain.

What is osteoarthritis?

Like Janet, 20 percent of adults in the United States have been diagnosed with arthritis, according to the Centers for Disease Control and Prevention. Three of five Americans ages 65 and older are affected by arthritis.

Janet had osteoarthritis - one of the most common forms of arthritis. It is among the more than 100 forms of the disease.

Osteoarthritis is referred to as the wear-and-tear arthritis and occurs when the protective cartilage on the ends of bone wears down over time. Symptoms may include pain, warmth, swelling or stiffness in the joint.

“Mild joint pain that occurs with activity can generally be controlled with self-help measures,” Dr. Abraham said.

“Rest, topical ointments and use of over-the-counter medications — such as aspirin and ibuprofen - are usually effective in treating mild cases.”

When should a patient consult a medical professional?

Dr. Abraham recommends seeking medical attention when the condition affects an individual’s lifestyle. Individuals should see a physician when stiffness and swelling:

•Cannot be relieved by rest or reduced by home remedies and over-the-counter medications

•Occur even when someone is not involved in activity

•Interfere with the ability to perform many activities, such as climbing stairs and bending over

•Awakens the individual from sleep


A variety of nonsurgical treatments, such as exercise, steroid injections and joint fluid therapy, are available.

The final option is surgery, such as arthroscopic (removal of the damaged cartilage) and joint replacement (replacement of the damaged joint with a metal and plastic joint).

Patients with severe arthritis may consider joint replacement if they experience:

•Unbearable pain after conservative treatment

•Symptoms that significantly affect their ability to perform normal activities

•Pain that regularly interferes with sleep

•Pain and loss of mobility that greatly affect the quality of life

Knee replacements have proven to be a very successful way to treat many patients

“A variety of techniques are available for knee surgery. Minimally invasive knee surgery involves the use of a smaller incision to remove and replace a damaged knee,” Dr. Abraham explained. “For many patients, this technique may result in less surgical pain, a shorter hospital stay, accelerated rehabilitation and a faster recovery.

“While arthritis can be very painful, the good news is that with early intervention, symptom control and minor lifestyle modification, many patients can manage the condition and participate in many of their everyday activities with little or no pain,” he said.

Through the years, knee replacement has proven to be a very successful way to treat many patients without serious complications, according to Dr. Abraham.

To request an appointment with Dr. Abraham or another Tri Rivers physician, visit "request an appointment" on tririversortho.com or call 1-866-874-7483.

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