It’s a Boy!

July 31, 2013

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On the evening of July 22, 2013, the fountains of Trafalger Square in London were gloriously illuminated by blue lights, signifying the heir to the British throne, Prince William, and his wife, Kate Middleton, had given birth to a prince. His Royal Highness, Prince George Alexander Louis of Cambridge, came into the world at a healthy weight of 8 pounds, 6 ounces and it seems the entire world took a collective breath.

In a time of 24-hour news cycles and second-by-second social network updates, the birth of the royal baby was the stuff of water-cooler discussions around the world. In fact, British bookmaker, Coral, noted that this birth was the biggest, non-sporting betting event in history. Everyone, it seems, is talking about babies and moms, royal and otherwise those of us at Texas Back Institute are no exceptions.

The spine specialists at Texas Back Institute treat many new mothers and mothers-to-be who are experiencing back pain associated with childbirth. While the world is fascinated with little Prince George, we chatted with Dr. Nayan Patel whose expertise in physical medicine and rehabilitation makes him an excellent source for analyzing the causes of back pain among pregnant and post-partum women. His insights shine some medical light on the back pain millions of mothers experience. However, before getting his thoughts, let’s take a look at the impact the newest prince has had already.

It’s a Boy!

With this much interest in the birth of Britain’s latest heir, one could predict some ripples running through the media and even the economy as a whole. However, very few could anticipate the tsunami of media coverage and economic impact transpiring immediately before and after the July 22nd birthdate.

On the economic front, the British birth has been very good for business – worldwide – resulting in a feel good bump in sales in a wide range of categories. The UK-based Centre for Retail Research estimates England will get a $373 million (US) boost, with $133 million in festivities, $123 million in souvenirs and toys and $117 million in books and DVDs. Because Americans and Australians can’t seem to get enough of the royal child, it expects exports to these two countries to exceed $57 million in sales.

Because of the popularity of the royal couple and their new baby, whatever choices they make in the way of “baby accoutrements” will likely drive big sales worldwide. Experts say the sales of prams and baby pushchairs should increase dramatically. They expect whatever baby clothes, cribs and toys the royals buy for little George will get the Baby Cambridge bounce.

Even US – based retailer, Target is celebrating the arrival of the royal baby. This company has been featuring Princess Kate’s maternity clothing throughout her pregnancy and is selling a special line of baby clothes in honor of the newest prince. Target’s campaign theme – “We may not know anything about being third in line to Britain’s throne, but we know about babies (and their first-time moms and dads)”- suggests a reason for our fascination with this event. More on that later.

A Royal Pain in the Back

When all the media noise dies down (if only for a few hours) and Princess Kate is left alone to enjoy some quiet time with her baby, there is a very good possibility she will be left to deal with the problem that new moms everywhere have to deal with – chronic back pain. This pain often accompanies pregnancy and continues in many post-partum women.

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Dr. Nayan Patel of Texas Back Institute notes, “Back pain occurs in approximately 50 percent of pregnant women on some level. It can start as early at the first trimester and continue for as long as 18-months after delivery. It can be very painful and adds to the stress of being a new mom.”

What causes this pain? Dr. Patel says, “Many people feel the added weight of the baby strains the back muscles and causes pain. However, in most cases, the real culprit for the pain is the perfectly natural process of a hormone being released in a pregnant women’s system to allow for the muscle ligaments to expand and allow for the passage of the baby through the birth canal.”

Dr. Patel continued, “This can lead to a condition known as ligamentous laxity – basically loose ligaments – which can lead to sacroiliac joint dysfunction and pain. The sacroiliac joint is the joint in the bony pelvis between the sacrum and the ilium of the pelvis which are joined by strong ligaments. The sacrum supports the spine and is supported by an ilium on each side.”

How does Dr. Patel treat this condition? “With women who are pregnant, we are very careful to avoid anti-inflammatory medicines because the baby is receiving everything the mother is ingesting. So, for pregnant women, we often prescribe a visit to the chiropractor for adjustment therapy and physical therapy, especially aquatic therapy. As for post-partum back pain, we typically prescribe the anti-inflammatory medicines and if the pain continues, physical therapy,” he notes.

“Women who are pregnant are typically younger and this is case with Princess Kate. This youth allows the muscles and ligaments to rehabilitate quicker and if Prince George’s mom is experiencing any back pain, she will likely recover quickly.”

Why We are Fascinated by the Royal Baby

Whether Princess Kate has a royal pain in the back or not, she is without doubt the most high profile mom of the decade and perhaps in history.  What is it about this event that fascinates people around the world?  Child birth is the most common occurrence on the planet, and yet we can’t seem to get enough details about the royal birth.

Some of the more philosophical pundits and pop culture observers have suggested a reason for this fascination. The marriage of the British heir to the throne, Price William, to Kate Middleton a commoner was similar to a fairy tale to many people. The couple is charming and attractive and they are a real-life prince and princess. Their having a beautiful baby just enhances the fairy tale. And after all, most of us love happy endings in our fairy tales!

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In many ways, social media such as Facebook and Twitter are more a blessing than a curse for healthcare. Just ask Cheryl Zapata, Chief Development Officer at Texas Back Institute. Each week, more and more of her professional hours are spent researching the ways social media can help the physicians and professional staff of this 36-year old practice continue to deliver world class spine care.

While many, if not most, individuals use Facebook to LIKE the latest movie or keep up with the activities of friends and YouTube to see the latest TV show or music video, a medical practice such as Texas Back Institute has more serious, long-range goals for these revolutionary communication tools.

These plans are being formulated in the context of strict adherence to patient care and privacy. While the social media objectives of Texas Back Institute are quite serious, the brilliance of these social media and the reason for their meteoric rise in popularity among almost every age group partially lies in their informal and fun presentation of vast amounts of content. In the social media world, content is indeed king.

The executive team and physicians at Texas Back Institute recognize the amazing power for health information and patient-centered care social media such as Facebook, Twitter, YouTube and blogs can deliver. There has never been a more powerful healthcare communication tool than social media as a few quick examples will suggest.

Social Media is Affecting Healthcare Now

The foundation of social media is a very powerful form of crowdsourcing.  This term, coined in 2006, is defined by several online dictionaries as the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people, and especially from an online community. It combines the efforts of “crowds” of self-identified volunteers, workers, friends on Facebook and followers on Twitter where each one on their own initiative adds a small portion that combines into a greater result.

Healthcare has many examples where the crowdsourcing aspect of social media enabled meaningful data for patient care. Epidemiology, which is the study of patterns and causes of illness and diseases among a given group, has used social media to solve healthcare mysteries in several, high profile cases.

For example, the July 18, 2013, edition of Clinical Infectious Diseases, it was noted  Facebook users in Minnesota were able to identify tainted food as the source of a strep throat outbreak. The outbreak affected 18 of 63 attendees at a banquet and after seeing multiple posts about team members falling ill, a parent alerted the Minnesota Health Department which conducted phone interviews and analyzed DNA from strep samples eventually determining the source of the illness was a pasta dish at the banquet.    

This was not the first case solved by social media. The Los Angeles County Department of Public Health used social media to trace an outbreak of Legionnaire’s Disease at a trade conference held at the Playboy Mansion in Los Angeles in 2011. Last year, a social media-public health company called “Sickweather” accurately predicted the 2012 flu season six months in advance of the Center for Disease Control by using social media trend tracking. Clearly, social media is already involved in the delivery of healthcare.

Building a Community with Social Media

Many physicians, hospitals, clinics and healthcare executives are extremely mindful and even concerned about inappropriate use of social media by healthcare professionals. This causes a reluctance to embrace these tools. However, the fact remains these media are already being used to positively impact patient outcomes and they may be the most powerful tools to date for the practice of medicine.

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Cheryl Zapata believes when the medical practice goals and business practices of Texas Back Institute are properly aligned with social media, positive patient outcomes can occur. “The big thing social media can do for our practice is to build a community, where everyone – the patients, physicians and professional staff – is focused on patient care, pre-surgical education, preventative health practices and post-surgical therapy.”

She continued by noting, “We want our patients, our physicians and staff to be a part of something important. This community can be informed and built by timely and relevant social media content and we can glean insights about better patient care by monitoring these social media. Social media platforms are robust and extremely user friendly and it’s incumbent on us to take advantage of these communication tools.”

“We want more conversations among our physicians and patients, not less,” she noted. “And we want our physicians to be comfortable with the transparency social media affords.”

Even this blog you are reading is a part of the Texas Back Institute’s commitment to community building. “We focus considerable resources on building the ‘smart content’ in this blog which is updated every week and often several times per week. We want to be a part of the conversation our patients, physicians and staff are having. Perhaps this involves a blog post dealing “water cooler conversations” – sports injuries, news or technology – and how this topic relates to back injuries and health. If so, all the better.  We want to be relevant, accurate, timely and sometime entertaining.”

Post Your Comment

Texas Back Institute has built an international reputation through its leading-edge medical advances. For example, artificial disc replacement procedures were pioneered by the physicians at Texas Back Institute and it helped introduce this technology to the U.S. This same, innovative spirit is evident in the social media plans for organization.

The next time you see a YouTube video of information about post-surgical recovery of one our patients or a blog post about the back injuries and recoveries of Major League Baseball players; don’t forget to post a comment. We want to know what you’re thinking and how we can make this community even better!

All Star Back Care

July 15, 2013

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When Dr. Rey Bosita of The Texas Back Institute talks about back health and baseball, his voice reveals his passion for both subjects. He clearly loves the game and his medical profession. This makes Dr. Bosita the ideal source to share information and opinions about the 2013 Major League Baseball All-Star game and how these athletes deal with back injuries.

Since Texas Back Institute is the Official Spine Specialist for the Frisco RoughRiders, the AA affiliate of the Texas Rangers baseball club, Bosita knows all about baseball-oriented back injuries. Before getting his thoughts on back injuries and ball players, let’s take a brief look at the 2013 MLB All-Star game.

The Fan Favorites

This year’s All-Star game will be played at Citi Field in New York City, the home field for the National Leagues New York Mets, on Tuesday evening, July 16, 2013. As always, the game will be nationally televised on Fox and the festivities begin at 7 p.m. (Central).

The MLB All-Star game owes much of its popularity to the fact that professional baseball fans can vote on the players who will take the field. Of course, this “popularity contest” format has gotten negative comments in the past – particularly from traditional baseball fans who feel that a player’s on-field abilities and performance in the first half of the season, rather than his name identification – more often than not, the popular vote reflects what type of season the starting lineup players are having. A great example of this is Baltimore Oriole’s first baseman, Chris Davis.

After being traded from the Texas Rangers to the O’s, Davis is having a remarkable year at the plate – 85 RBIs and 33 homeruns. In the All-Star voting, he finished with 8,272,243 fan votes to edge out last year’s triple-crown winner, Miguel Cabrera of the Detroit Tigers, who amassed 8,013,874 votes. Since neither plays for teams in large metropolitan markets, where vote totals can be manipulated by in-stadium promotions and both are having great years, it appears the fans made the correct, non-partisan, decision.

On the National League side, St. Louis catcher Yadier Molina was the leading vote-getter and he joins 4 other Cardinal teammates to make the Midseason Classic lineup. The NL player who has gotten lots of attention for his amazing season after being called up from the Los Angeles Dodgers minor league team, Yasiel Puig, failed to make the All-Star team this year.

2013 Major League Baseball All-Star Starting Lineups

The American League Starters include:

Joe Mauer (C – Twins)

Chris Davis (1-B – Orioles)

Robinson Cano (2-B – Yankees)

J.J. Hardy (SS – Orioles)

Miguel Cabrera (3-B – Tigers)

Mike Trout (OF – Angles)

Adam Jones (OF – Orioles)

Jose Bautista (OF – Blue Jays)

David Ortiz (DH – Red Sox)

For the National League:

Yadier Molina (Catcher – Cardinals)

Joey Votta (1B – Reds)

Brandon Phillips (2B – Reds)

Troy Tulowitzki (SS – Rockies)

David Wright (3B – Mets)

Carlos Beltran (OF – Cardinals)

Carlos Gonzales (OF – Rockies)

Bryce Harper (OF – Nationals)

Over the course of their careers, most if not all of these All-Stars have had to deal with injuries and some have been serious. Unlike football, baseball is considered a non-contact sport. However, there are more than a few collisions between runners trying to make it home and catcher trying to guard the plate and the constant swinging and throwing can take its toll on these athletes. Injuries to the spine and back are very common in this sport and we talked with Texas Back Institute surgeon, Dr. Rey Bosita to shed some light on how playing baseball can be dangerous to your back health.

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Now Batting – Dr. Rey Bosita

Dr. Bosita was between appointments when we caught up with him and asked him about the most common back ailments for professional baseball players. He said, “Lumbar sprains and other muscular strains are the most common back problems for baseball players. However, the most serious injury is a disc herniation. This involves the damage to the disc, which cushions the vertebra in the spinal column. When a player has a herniated disc, there is intense pain and any movement – whether it’s swinging a bat or throwing a baseball – almost impossible.”

So, what causes a herniated disc?

Dr. Bosita noted, “It can occur as a result of repetitive stress, for example if a player is swinging a bat for hundreds of times each week. A disc can be herniated when a player takes a powerful swing and misses or it can be the result of a collision on the base paths.”

Texas Back Institute is the Official Spine Specialist for the Frisco RoughRiders team and because they are just starting their careers in professional baseball, these players tend to be younger than those in the “big show” in Major League Baseball. Does the age of a player have any effect on the likelihood of back injuries?

“Definitely,” notes Dr. Bosita. “Older players have much more wear and tear on their back muscles, discs and vertebra and the constant repetitive stress from playing more than 160 games a year can gradually wear down these back muscles and cartilage. Plus, younger players tend to be in better condition and their muscles can withstand the quick starts and stops of baseball.”

Bosita was quick to note that some older players such as retired Baltimore infielder Cal Ripkin showed remarkable conditioning and ability to play with pain. “During his famous and historic complete games run, Ripkin played with a lumbar compression. This would have incapacitated most players, but Ripkin continued to play every day with this condition.”

What type of conditioning exercises do professional baseball players use to avoid the back sprains and other, more serious injuries?

Dr. Bosita said, “Cross training exercises which are designed to improve flexibility and strength and proper pre-workout stretching and post-workout cool downs are the most important elements of a conditioning regimen. Since baseball players are required to go from a complete stop to full-speed at the crack of a bat, it’s important that they remain loose even when they are in the dugout. Stretching will help with this.”

The All-Star Team at Texas Back Institute

The All-Stars who take to the field on July 16th are at the very top of their profession. Their conditioning is impeccable and their knowledge of potential injuries is extensive. And yet, the odds are very good that at some time, in the course of a season, they will experience a back injury that can potentially end their season or career.

If these athletes, with all of their physical conditioning and knowledge can be sidelined by back injury, it goes without saying that non-athletes can also experience the pain and physical limitation of back injury or pain. When this happens, it’s a good idea to go to the specialists – the All Stars – who deal with these issues every day: Texas Back Institute.

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Sizzling Safely

A sizzling barbecue, surf and sun at the beach or a symphony concert – however you choose to celebrate this Independence Day, we at Texas Back Institute hope you’ll do it safely – and remember the sacrifices of those in uniform. The US currently has about 68,000 service members in Afghanistan alone.

Many domestic military bases have cancelled traditional celebrations due to that $85 billion across-the-board spending reduction, otherwise known as the ‘sequester’.
Fort Hood officials confirmed this year’s on-post Fourth of July celebration will be significantly smaller. Camp Lejeune in North Carolina is one of the bases that won’t have fireworks at all this year.

Still, North Texas will have plenty of celebrations. We have a complete list here.

Cutbacks in public celebrations may mean more private celebrations. So – if you’re stocking up on the bottle rockets and firecrackers, please make safety a top priority!

Safety First:
(According to the US Consumer Product Safety Commission there were an estimated 9,600 fireworks-related injuries during the 4th of July season in 2011.)

Obey local laws. If fireworks are not legal where you live, do not use them.
Know your fireworks.  Read the warning labels and descriptions before igniting.
Parents and caretakers should always closely supervise teens if they are using fireworks.
Parents should not allow young children to handle or use fireworks.
Never attempt to alter or modify consumer fireworks.
Fireworks should only be used outdoors.
Always have water ready if you are shooting fireworks.
Always have a fire extinguisher ready.
Alcohol and fireworks do not mix.  Save your alcohol for after the show.
Report illegal explosives, like M-80s and quarter sticks, to the fire or police department.
Also, don’t forget the family dog may be frightened by the sound of fireworks. Be careful to properly protect this vulnerable family member from the potentially serious results of emotional anxiety, dangers of overreacting, and attempts to run away.

Fun July 4th Facts:

U.S. Population in July 1776: 2.5 million
Source: Historical Statistics of the United States: Colonial Times to 1970

The nation’s estimated population on this July Fourth: 316.2 million 
Source: U.S. and World Population Clock

Numbers of signers to the Declaration of Independence: 56

Benjamin Franklin, John Adams, Thomas Jefferson, Roger Sherman and Robert R. Livingston comprised the Committee of Five that drafted the Declaration. Jefferson, regarded as the strongest and most eloquent writer, wrote most of the document.

John Hancock, President of the Second Continental Congress, was the first signer. This merchant by trade did so in an entirely blank space making it the largest and most famous signature – hence the term John Hancock, which is still used today as a synonym for signature.

Benjamin Franklin (age 70), who represented Pennsylvania, was the oldest of the signers. Franklin County, Pa., had an estimated population of 151,275 as of July 1, 2012. Edward Rutledge (age 26), of South Carolina, was the youngest.

Two future presidents signed, John Adams (second President) and Thomas Jefferson (third President). Both died on the 50th anniversary of signing the Declaration (July 4, 1826). There are 12 counties nationwide named Adams and 26 named Jefferson.

Have a Happy July 4th!

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