“First and foremost, we’re looking for the best possible outcome,” says
Lalit Puri, MD, Orthopaedic Surgeon and Division Chair of Adult Reconstruction at NorthShore. And, according to Dr. Puri, the philosophy of the Total Joint Replacement Center at NorthShore is that the best possible outcomes are created from strong partnerships
between patients and healthcare professionals.
Dr. Puri shares more information on the partnerships formed between patients and their orthopaedic care teams at the NorthShore Total Joint Replacement Center:
Why is the partnership between patient and healthcare provider so important?
If we enter into a partnership with our patients, we’re asking the patient to give his or her best before and after surgery, just as we’ll give our best throughout as well.
We know that surgery can certainly be anxiety-provoking, but we don’t want patients to come into NorthShore feeling like that. So our partnerships are about trying to demystify the process. Our partnerships start with an open and honest dialogue.
Part of that demystification process is patient education. Why is educating the patient before surgery so important?
It’s critical that the patient has an understanding of what to expect before surgery. Most importantly because it reduces anxiety in the patient’s mind so that he or she is more comfortable with what’s ahead. I also think that the more educated a patient is
about surgery, the more he or she can participate in his or her care. A more informed patient has a better understanding of what is happening, and therefore may be a more active participant.
What does patient education at the Total Joint Replacement Center involve?
A key element of our partnership with the patient is our comprehensive Patient Education Program. This program guides patients through the entire process of a total joint replacement before surgery even happens, from pre-surgery preparation recommendations
to full rehabilitation.
Patients are encouraged to attend a class prior to surgery that is run by a team of specially trained orthopaedic nurses. In this class, they learn what they can do to be active participants in their own care, and have an opportunity to interact with many
of the clinicians who will be a part of their care teams.
The Patient Education Program is not just about educating patients though. Our multidisciplinary team uses this time to learn about the individual needs of each patient by asking and answering questions, getting to know each individual patient, to discover
the best way to help patients maximize their health before the surgical procedure.
Find out more about the Patient Education Program and Total Joint Replacement Center here:
Developing a regular exercise routine is one of the most important elements of a healthy lifestyle, and roughly 53% of Americans show their agreement by exercising three or more days a week. However, participation in any physical activity, whether it's hitting
the gym or the slopes, increases your risk for an exercise-related injury. Still, the health benefits of exercise far outweigh the risks, as long as you approach each new physical activity and sport armed with the right information.
Get fit but also stay safe with the help of our sports injury prevention infographic. Learn how to recognize common sports injuries that affect both athletes and energetic amateurs and use our simple, easy-to-follow sports injury prevention tips to keep
you pain free and active. Click on the link to view our full NorthShore University HealthSystem
The update to a report first published 25 years ago in the British Medical Journal continues to raise important questions about the value of mammography; however, it must be considered in the context of other randomized trials that
confirm a significant reduction of breast cancer mortality in women who regularly undergo screening mammograms. This report shows, as it did previously, an improvement in survival rates for women who had their breast cancer detected via mammogram before clinical
signs of cancer had become apparent.
As screening technology continues to evolve, screening guidelines may be modified. At present, there is convincing data that women should have annual screening mammograms beginning at 40, as suggested by the American Cancer Society’s guidelines. Those with
a strong family history or a genetic predisposition may begin screening earlier after consultation with their physician.
For more information on mammography services and locations at NorthShore, please visit
Chocolate is good for you! Sound too good to be true? Well, Happy Valentine's Day, because it's true.
Don't take that as permission to rush out and buy all the heart-shaped boxes of chocolate you can find this Valentine's Day. When it comes to chocolate's health benefits, type matters. Not all chocolate is created equal and moderating your consumption (regardless
of the type) is key.
Curtis Mann, MD, NorthShore Primary Care physician, breaks down the health benefits of chocolate and shares some tips for picking the "healthiest" chocolate just in time
for the heart's favorite holiday:
Have medications and physical therapy done little to relieve your joint pain? Are you hoping to find a way to get
back to the things you love without having to worry about pain? Total joint replacement might be the next step, but it’s a step you shouldn’t take without asking some important questions first.
Ravi Bashyal, MD, Orthopaedic Surgeon, specializing in minimally invasive hip and knee replacement surgery at NorthShore, answers questions on total joint
replacement surgery, from what makes someone a good candidate to recovery, rehabilitation and beyond:
Who is a good candidate for joint replacement surgery?
Total joint replacement surgery is an excellent option for patients who have "worn out" their hip or knee joint, found little relief from conservative management options such as injections or medications, and who feel that their worn-out joint is significantly
impacting their ability to enjoy their daily activities and life.
Are there minimally invasive options for total joint replacement?
Yes. There are many new techniques and implants that allow total joint replacements to be done now in a much less-invasive fashion than in the past. These innovations can allow for shorter surgical times, lower complication rates and faster recovery. Talk
to your surgeon about his/her personal approach, and how you might fit into this as an individual patient.
What should a total joint replacement patient do prior to surgery?
There are numerous steps one should complete prior to a joint replacement surgery:
First and foremost, meet with an orthopaedic surgeon to make sure you are a good candidate for this type of surgery. He or she can talk to you about possible risks, recovery times and patient outcomes. Also make an appointment with your medical doctor and
any other specialists (i.e. cardiologist) to make sure you are medically cleared to safely proceed with surgery.
Attend a class regarding joint replacement at the NorthShore Total Joint Replacement Center. This is an excellent opportunity to participate in a program focused on hip and knee replacement. You'll have a chance to meet with nurses, physical therapists,
social workers, and other team members that will explain the ins and outs of what to expect before, during and after your surgery and during your hospital stay.
Make a pre-operative appointment with your surgeon and his/her team. This will give you a chance to review what you have learned during the pre-operative process, discuss any questions/concerns that may have come up, and to feel comfortable and confident
going into your surgery.
What can a patient do to help to ensure the best possible outcome?
Become a partner in your care. The Total Joint Replacement Center at NorthShore is there to guide patients from beginning to end, from pre-op to rehabilitation. Patients are encouraged to communicate with their surgeon but also with our highly trained orthopaedic
nurses and staff throughout the process. We feel that it’s important for our patients to have a thorough understanding of what to expect before, during and after surgery.
How long should you expect to be in the hospital after a total joint replacement?
Most of our hip-replacement and knee-replacement patients are ready to be discharged 2-3 days after their operation. Some patients are even ready to go home the day after. Many of our patients go directly home after surgery with in-home nursing and therapy
arranged by our social work team, while others elect to go to an inpatient rehab center prior to going home. Ask your surgeon what to expect, and discuss with him/her what would work best for your individual situation and preference.
While recovery time varies case by case, what timeframe for recovery should a patient of total joint replacement expect?
Recovery is different for everyone. With our use of minimally invasive techniques and advanced post-operative care, many patients are recovering at a much quicker pace than 10 or 15 years ago. We have many patients back to work and activities within a few weeks.
Of course, this is subject to individual recovery times, and the specific activities that each patient will return to after surgery. A discussion with your surgeon about your recovery is an important part of the pre-operative process.
What about long-term? How long should someone expect an implant to last?
Innovations in joint replacement technology have dramatically increased the longevity of many types of implants. Many currently available implants can survive for 20 or more years, and even if these devices "wear out," currently technology allows us to replace
only the worn-out part without having to re-do the entire operation or replace all the parts.
Dunlap, MD, Orthopaedic Surgeon and Sports Medicine specialist at NorthShore, has been treating elite-level hockey players since 2009. He has worked with USA Hockey as a team physician during tournaments in the United States and Europe. As a former college
hockey player, his own personal athletic experience provides insight into the way athletes think, both in injury and health.
Here, he tells us what inspired his pursuit of sports medicine and why getting an athlete back in the game is the biggest reward of all:
Were you a hockey player yourself?
I grew up playing hockey starting at the age of five and played through college at Yale University. I still play occasionally in adult hockey leagues and am on the ice several times a week helping coach my nine-year-old son’s team. My daughters, ages four and
five, are also on the ice, learning to skate.
What made you choose sports medicine/orthopaedics as a specialty?
I sustained a knee injury that required surgery while playing hockey my freshman year in college. My surgeon was a former Yale football player and he did a great job taking care of me. He got me back on the ice without missing a beat. That’s what sparked
my interest in orthopaedics and, in particular, sports medicine. I love working with motivated athletes, helping them to get back to the best of their abilities. I feel that as a former athlete, I have some insight into how athletes think and take great joy
in seeing them get back into the game.
What is the day-to-day like for a team physician, particularly as a physician of hockey players?
There is actually a lot of down time covering these tournaments. I love being around hockey, talking hockey with the players, coaches and training staff so I get to be around that during these tournaments. Typically, I consult with the training staff
and evaluate players before and after practice and am obviously ready should there be any injuries that occur during game play. While there are the more significant injuries to tend to (lacerations, dislocations, concussions), many times it’s just as important
to make sure that things such as pink eye don’t spread throughout the team or that a player with the flu has a separate water bottle from the rest of the team. Hockey players in general are great to deal with. The perception is that hockey players are rough
and tough, but they actually tend to be good-natured, down to earth, and appreciative of the help we can provide.
What challenges have you encountered as a hockey team physician?
As with any elite athletes, the players we work with are incredible competitors. They love hockey and they love to be on the ice. However, it can be difficult at times as they can minimize the significance of injuries, especially those that require
subjective complaints and feedback such as concussions. It is my job to make sure we look out for the athlete’s best interest and health, both short-term and long-term. It can be unpopular to pull a player off the ice, but if it’s the right thing to do then
that is ultimately my job and that is why I’m there with the team.
What are the rewards of working with elite athletes?
The biggest reward is seeing the players succeed. The team physician is just one cog in the wheel to maximize and optimize the players’ abilities. There is also personal satisfaction for me in being able to combine two of my passions: hockey and medicine.
How does your work with USA Hockey inform your treatment of other patients?
I think working with athletes of any level is fundamentally the same. Is there a difference between working with the elite young athletes at USA Hockey who will someday make hockey their profession and a weekend warrior who just needs to be able to be on the
ice or court Saturday afternoon? Absolutely. But my goal is the same: to keep them in the action and maximize their ability to compete and be at their best.
For an athlete there is nothing worse than suffering a sports injury that takes him/her out of competition. While some
injuries require more rest and rehabilitation than others, those who undergo surgery for an anterior cruciate ligament (ACL) injury need to take it slow before heading back into play.
In most cases, ACL surgery is done through small incisions, or arthroscopic surgery, rather than open surgery. Not only does this help reduce scarring and decrease recovery time but it can also help reduce complications and risks. Often the surgery is performed
on an outpatient basis, meaning the patient won’t have to spend even a night in the hospital. Outpatient surgery doesn’t make recovery any less serious, however.
Patrick Birmingham, MD, Orthopaedic Surgery and Sports Medicine at NorthShore, shares his tips for ensuring a safe and
speedy recovery from ACL surgery:
Have you had ACL surgery or know someone who has?
The Food and Drug Administration (FDA) announced in 2013 that it plans to label partially hydrogenated oils (PHO’s),
which are the primary dietary source of trans fats, as not generally recognized as safe for use in food. This relabeling of trans fats is just the first move in a process that will likely lead to a ban on trans fats in the U.S. food supply.
Trans fat first entered the American food supply in 1911 in the form of Crisco shortening. Fairly early in its history, preliminary studies show that trans fats could be more harmful than other fats. Later studies confirmed this finding, indicating that
trans fat contributed to heart disease. While their presence has already been greatly reduced in the food supply, trans fats can still be found in many processed foods, like frozen pizzas, microwave popcorn, baked goods, margarine and store-bought icings.
Philip Krause, MD, Director for the Section of Cardiology at NorthShore Skokie Hospital, explains why doctors have long urged their
patients to stay away from trans fats:
Notably, manufacturers have made steps to reduce fat levels in many foods and products. Since 2006, after which food labels reported trans fat content, intake of this substance has dropped significantly.
It is hoped, after the FDA finalizes its preliminary determination, PHO’s would be considered as “food additives” and could only be used with prior authorization. The primary goal and hope is that with better consumer education and these changes in product
and food manufacturing, Americans can look forward to much healthier life ahead.
National Blood Donor Month is a time to celebrate both the generosity of current volunteer blood donors and encourage others to register as donors and start making regular lifesaving donations of their own. In recognition of National Blood Donor Month, NorthShore
University HealthSystem has created an infographic that highlights important facts and statistics of blood donation, from the time it takes to make a donation, to a breakdown of blood types and more.
Share our infographic with your friends and family and encourage them to consider donating to our own NorthShore Evanston Hospital Blood Bank. Click on the image
below to view our full National Blood Donor Month infographic.
Are you contemplating going gluten-free? Gluten-free products now line the aisles of the grocery store, and it seems more
and more people are adopting the gluten-free lifestyle. But is it right for you?
Geeta Maker-Clark, MD, Integrative Medicine at NorthShore, answers questions on all things gluten, from the difference
between gluten sensitivity and celiac disease to going gluten-free for weight loss.
What is the difference between celiac disease and gluten sensitivity? If it isn't an allergy issue why would some people's bodies react to it?
Celiac disease and gluten sensitivity involve two different responses to the gluten protein, which is found in wheat, barley and rye. The symptoms of both conditions can be very similar, which makes it difficult to determine which one you might have
(if either) without the use of a lab test. We can check for celiac but not for gluten sensitivity with a lab test.
Celiac disease occurs when gluten triggers your immune system to attack the lining of your small intestine. The condition is autoimmune in nature, which means gluten doesn't cause the damage directly; instead, your immune system's reaction to the gluten
protein triggers the cells to mistakenly attack the lining of your small intestine.
The theory around gluten sensitivity or intolerance is that a person experiences a direct reaction to gluten, or, in other words, the body views the protein as an invader and fights it with inflammation both inside and outside your digestive tract.
Is there a test for gluten sensitivity?
There are no good lab indicators for gluten sensitivity. You can be tested for celiac disease. But, if this is negative, it does not mean that you are not gluten sensitive. The best indicator is to try an elimination diet and see if your symptoms improve.
This is the gold standard.
What are the drawbacks of a gluten-free diet?
The main drawback to a gluten-free diet is the effort. One needs to prepare in advance by looking through the pantry and refrigerator, reading ingredients on labels, and understanding what contains gluten so it’s not consumed. It’s very helpful to
have a cookbook or some recipes in place so that you have what you need to make the trial successful. Some foods labeled as gluten-free are high in fat and sugar, so this needs to be considered when purchasing. That being said, I have scores of patients who
have done this successfully, felt much better and then were motivated to continue.
What is the best basic way to begin gluten-free lifestyle?
I think that the best way to begin is to clean out your kitchen and pantry of things you can no longer eat. Removing the temptations will make this lifestyle shift easier for you. Next you can focus on fresh, whole foods such as produce, grains and fish. Become
a label reader and familiarize yourself with the hiding places of gluten. There are some great supportive gluten-free living blogs online, gluten-free smartphone apps that will tell you what you can buy in the grocery store, and excellent cookbooks too. There
is a lot out there to support you on your path!
Some people go gluten-free to control their weight. Is there any risk in that?
A gluten-free diet is not a good way to approach weight loss, if that is the goal. Some people who are gluten-free do lose weight, but usually because they are consuming fewer calories overall when they eliminate baked goods, bread, etc.
The gluten-free diet can lead to weight gain if one is consuming enough gluten-free food, or processed foods high in fat and sugar. I would not recommend a gluten-free diet for those looking to lose weight. A balanced diet high in fresh, whole foods and
low in processed food, as well as an active lifestyle would be a more effective method.
If a gluten-free diet has improved digestive symptoms of celiac disease, should you still be tested for celiac disease?
It is very important that you do find out if you have celiac disease, as this information can help guide your lifestyle as well as help your family understand their risks because there is a genetic component to celiac disease. This can be accomplished
with a blood test ordered by your doctor.
Is there a relationship between ulcerative colitis and gluten?"
While there is no evidence that gluten causes ulcerative colitis, it may trigger symptoms in some people who are sensitive to it; thus, it may be useful to try a gluten elimination diet for three weeks to see if symptoms improve. There is no risk in
doing it, so it is a reasonable option.
Can a gluten-free diet help treat Barrett's esophagus?
Whenever I’m considering an inflammatory disease process, especially when related to the GI tract, I always discuss an anti-inflammatory plant-based diet. Of course this is most helpful to prevent disease, but it does have a role in treatment as well.
Barrett's esophagus occurs after chronic insult to the esophageal lining over time. Losing weight and eating a diet high in anti-oxidants, like colorful fruits and veggies, are an important part of the treatment. A gluten-free diet is a reasonable step as
well to see if acid reflux symptoms improve. Since Barrett's is diagnosed by upper GI endoscopy and biopsy, the only way to know if a gluten-free diet is helping would be to repeat these same tests later with your gastroenterologist.
Could a gluten-free diet help with the symptoms of hypothyroidism?
People with celiac disease or gluten sensitivity often have gastrointestinal symptoms like gas, bloating, diarrhea and abdominal pain after eating. There are people with autoimmune thyroid disease and other autoimmune diseases who also do much better with a
gluten-free diet, so I do utilize the elimination diet for 3-4 weeks as a trial. There is no risk in trying, but it does take some preparation to successfully eliminate the gluten from your diet.