Ask the Doctor: Summer 2017

boy in blue soccer uniform kicking ball in chattanooga
Q. My son just recovered from an ankle sprain and is back on the soccer field. What is the best way to protect against re-injury?

A. Ankle sprains are a common injury accounting for approximately 30% of all sport-related injuries. Of those 30%, approximately 20-30% develop into chronic ankle instability, which can lead to lifelong consequences on and off the playing field. Recovering from an ankle sprain depends on the severity and should be assessed by your foot and ankle specialist. Treatment focuses on decreasing swelling and tenderness and protecting and stabilizing the ankle ligaments, followed by ankle rehabilitation to regain motion and strength.

Since your son seems to be past the initial injury phase, I recommend two ways to protect against re-injury the rest of his soccer season:

Braces or ankle taping by his athletic trainer will increase his “stabilization strength” and proprioception. Proprioception is our ankle’s ability to communicate effectively with our brain to contract muscles in correct patterns to produce stability.

Secondly, consult with your physical therapist to formulate a home exercise plan to strengthen and increase endurance with isokinetic (muscle strengthening) exercises, as well as progress proprioceptive training.

C. Jason Wamack Dpm facfas foot and ankle surgeon center for sports medicine and orthopaedics chattanooga

Q. What is pharmacogenomics?

A. Every day, doctors make important medical decisions based on little more than an intake questionnaire, a brief family history, and a cursory physical examination. If you’ve ever wondered why one medicine may work wonders for one person and seemingly do nothing for someone else – the answer is pharmacogenomics.

Pharmacogenomics is the study of how subtle variations in your genes can have a profound effect on the way a drug behaves. Doctors know the liver is home to the CYP450 superfamily of enzymes that are responsible for metabolizing more than 80% of all prescription medications. Blood pressure, diabetic, and cholesterol-lowering medications, to name a few, must ultimately make their way through the liver.

Pharmacogenomic testing, in the form of a simple cheek swab, allows doctors to know whether a patient may be a “poor,” “intermediate,” or “rapid” metabolizer of certain high-risk medications and even herbal or food supplements. No more “trial and error” in other words. Precision prescribing means personalized treatment, fewer side-effects and a more successful, rapidly effective treatment program.

Kerry D. Friesen md medical director and lead consultant the friesen center chattanooga

spine illustration chattanooga
Q. I have been experiencing sharp pain running from my lower back all the way down my leg. How can I find relief?

A. Pain running down the back or side of the leg typically suggests a pinched nerve in the back (sciatica). Nerves in the back power muscles in the legs and provide sensation. When a nerve in the low back is squeezed, pain, numbness, and weakness result.

One of the most common causes of sciatica is a herniated disc or a bone spur. Less common causes include a fracture, infection, or a tumor.

After proper confirmation of the diagnosis, treatment usually varies upon the severity of the pain. Often, time and anti-inflammatory medications improve the pain. For persistent symptoms, physical therapy and chiropractics can help.   

In severe cases, epidural steroid injections or surgical procedures might be necessary to relieve radiating leg pain. Many modern techniques involve minimally invasive incisions with quicker recovery and less risk of infection. Typically, intra-operative CT scans are used to increase accuracy and minimize the incision length.

jay jolley md spine specialist and surgeon southeastern spine chattanooga

Q. What are the warning signs of stroke? Is there a way to lessen my risk?

A. The following are the common warning signs of stroke:

– Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body

– Sudden confusion, trouble speaking or understanding

– Sudden trouble seeing or blurred vision in one or both eyes

– Sudden trouble walking, dizziness, loss of balance or coordination

– Sudden severe headache with no known cause

You can reduce the risk of stroke by modifying your lifestyle through losing weight, drinking less alcohol, consuming less salt, exercising, quitting smoking, and eating healthy.

Additionally, you can reduce the risk of stroke by keeping certain medical conditions including hypertension (high blood pressure), high cholesterol, diabetes, and atrial fibrillation (irregular heartbeat due to abnormal electrical conduction in the heart) under control.

Amjad Munir md medical director healthsouth chattanooga

allergy shot medication syringe and medication chattanooga
Q. I have terrible allergies in the spring and summer and was told allergy shots might provide relief. How do they work?

A. Allergy shots work like a vaccine. Your body responds to injected amounts of a particular allergen (pollen, mold, pet dander, etc.), given in gradually increasing doses, by developing immunity or tolerance to the allergen. The injections help your body stop reacting to your environment, thereby decreasing the allergy symptoms and the need for allergy medicines.

There are two phases:

Build-up phase. This phase involves receiving injections with increasing amounts of the allergen one to two times per week. The length of this phase depends upon how often the injections are received, but generally ranges from three to six months.

Maintenance phase. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase. During the maintenance phase, there will be longer periods of time between treatments, ranging from two to four weeks. Your allergist/immunologist will decide what range is best for you.

Allergy shots are not only a cost-effective, all-natural cure for allergies, but they also can prevent asthma development in over 50% of patients if started early in childhood.

Marc w. cromie md allergist chattanooga allergy clinic

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