Dr. Ruhlman Featured in Swedish Ballard

This is Swedish Ballard’s third post in a four-part series to encourage and inspire Ballard residents and the surrounding communities to be healthy while leading active lifestyles in 2014.  Below, posted in its entirety, is the article from Swedish Ballard’s web site; posted 1/29/14.

By Scott Ruhlman, MD
Orthopedic Surgeon

Looking to be more active in 2014? Have you been waiting all year to enjoy winter sports such as skiing or snowboarding?

There are a few common injuries that often get my patients down when they are on the go. Below are a few tips and tricks to help you prevent these common injuries and determine the best treatment options should you need it.

Sprains/Fractures
The most common injuries in the wrist and ankle are sprains and fractures. Throwing, twisting, weight-bearing, and impact can put you at risk for a wrist injury. Ankle sprains and fractures are typically caused by making a fast, shifting movement with your foot planted on the ground.

In most cases, I recommend the RICE approach: rest for around 48 hours; ice the injured area to reduce swelling (use a pack wrapped in a towel); compress with an elastic ACE wrap; and elevate the injury above heart level.

However, if you experience these symptoms, contact your provider for further evaluation.

  • Pain at the time of injury
  • Swelling
  • Bruising or discoloration
  • Difficulty moving the wrist or ankle
  • A “popping” or tearing sensation during the trauma
  • Warmth and tenderness of the skin

More serious injuries will likely be treated with a splint, boot or cast. The healing process can take up to six weeks. Surgery may also be required.

ACL Tears
The ACL, or anterior cruciate ligament, is one of the major ligaments in your knee that helps with stabilization when turning or planting. ACL injuries take place during cutting or pivoting movements. The hallmark of a torn ACL is a distinct popping noise and your knee may give out. The affected knee will begin to swell and become stiff between 2-12 hours after the injury. People often experience pain or tenderness, and discomfort while standing or walking.

Treatment for ACL injuries depend on the severity of the tear, as well as your age and activity level. Non-surgical treatment such as physical therapy or using a brace may be sufficient. Other individuals will need reconstructive surgery. In all cases, it is important to consult with your provider as soon as possible if you suspect a problem.

Rotator Cuff Tears
The rotator cuff is a group of four small muscles and tendons in the shoulder that provide stability to the shoulder and mobility to the arm. A torn rotator cuff can happen in two ways. An acute tear happens suddenly, such as when you fall on an outstretched hand or lift a heavy object. Tears can also happen slowly over time. As we age, the tendons of the rotator cuff become weaker and gradually fray.

Symptoms of a rotator cuff tear include pain with movement of the shoulder and tenderness to touch. Inability to lift even household objects out to the side or overhead is also typical. Another indicator is a prior history of shoulder tendonitis or bursitis as this would point to excessive stress on the rotator cuff over time.

Treatment can be conservative for some tears, including physical therapy to improve shoulder mobility and progressively strengthen the cuff muscles. However, the majority of tears will likely require surgery to restore shoulder function.

Meniscus Tears
The meniscus helps to absorb shock, as well as stabilize the knee joint. A lot of your body weight is distributed through the meniscus when you move, especially when performing athletic activity. Meniscus tears are caused by twisting and compression that can occur with such activities as running or jumping.

If you have a meniscus tear, you may hear a popping sound or feel a tear or rip in the knee. Swelling generally occurs within a few minutes to a couple of hours and your knee might feel like it is out of place. In less acute injuries, swelling may not occur. Your knee might feel like it’s catching during movement, or like it’s “out of place”. If you suspect you may have a meniscus tear, make an appointment with your provider right away.

Initial treatment of a meniscal tear is typically nonsurgical, and may include RICE (rest, ice, compression and elevation). If the tear doesn’t heal, you may need surgery.

Prevention
While the majority of these sports injuries are due to circumstance and pre-existing injuries, there are precautions that you can take to help prevent them from happening to you:

  • Maintaining a lifestyle involving consistent exercise
  • Warming up and stretching prior to rigorous activities
  • Cooling down and slowly relaxing after exercise.

Dr. Scott Ruhlman practices orthopedic surgery at Orthopedic Specialists of Seattle, and has extensive experience with sports medicine. If you have any questions regarding your shoulder pain or function, please feel free to contact Dr. Ruhlman’s office at (206) 784-8833.

Google Glass Technology: 21st Century Solutions for Medical Professionals and Their Patients

Have you heard of Google Glass?  It’s a new form of technology that has the potential to facilitate better and more efficient patient care.

Carl Spitzer, M.D. and Craig Rosenberg, Ph.D. are the founders of the startup company Healium, based in Seattle, WA. They developed software for Google Glass with an eye on how wearable computing can help physicians.

This latest technology development has particular significance for Spitzer, according to the King5 article, is not only a practicing emergency physician at Marin General Hospital, but is also its chief medical informatics officer. It’s his job to research the latest technologies and see if there are applications for his profession.  According to King5’s article, Dr. Spitzer said, “I saw this as an opportunity to kind of create a solution that would serve my needs and the needs of the doctors that I’m serving, and also help patients.” The article goes on to say that Healium’s application provides patient intake information in the Glass heads-up display, and real-time communications with other doctors or facilities. Doctors and paramedics wearing Healium-powered Glass can record videos and send/receive them for consultation.  Rosenberg, with a deep background in user experience and systems design in a variety of industries, is Healium’s chief technology officer. He and Spitzer view the hands-free nature of Glass as a potential advantage for ER physicians as well as first responders.

Dr. Ruhlman from OSS had this to say about this new technology, “It would be very helpful to go back to the imaging (x-rays, etc.) very quickly with Google Glass, or even more powerfully, to be able to have access with other surgeons – to have an interoperative consultation with somebody 3,000 miles away – to say, hey, I’m looking at this, you see it, what do you think?”

King5 explains that Healium’s application provides patient intake information in the Glass heads-up display, and real-time communications with other doctors or facilities. Doctors and paramedics wearing Healium-powered Glass can record videos and send/receive them for consultation.  Those qualities highlight what Spitzer sees as the benefits of Glass for physicians – “the fact that it’s wearable, the fact that it’s on all the time and I can consult with it in the middle of a trauma resuscitation, or in the middle of interviewing a patient,” he said. “I can be seeing a patient in one room and get called by the nurse about a patient in another room, and be able to reference their lab results, their x-rays.”  He goes on to say, “It’s one thing to hear that report,” Spitzer said, “It’s another thing to see the accident scene and to see the extrication (patient removal from accident wreckage) and that actually kind of helps to set the level of expectation for the types of injuries to expect, so it’s another way that it can positively impact patient care.”

Spitzer also believes it will be easier – not to mention less expensive and time-consuming – for physicians to simply record their patient interviews via Glass and then transfer that information into electronic health records. He’s also aware of questions regarding patient privacy/confidentiality, so transparency and giving patients the ability to opt out are important.

Read the full article here and check out Dr. Ruhlman’s thoughts in the video from King5 regarding this new, emerging technology:  http://www.king5.com/news/technology/Seattle-medical-startup-focuses-on-Google-Glass-for-emergency-rooms-242260021.html

Dr. Ruhlman’s Trip to Kenya

Last month OSS reported that Dr. Ruhlman and his family were leaving for Kenya once again.

They are back and this is what Dr. Ruhlman had to say about his travels with his family,

“I had the pleasure once again to travel this winter to Kenya to serve in an underprivileged area, providing orthopedic surgical care to patients in a small rural hospital in Bomet, Kenya. This was my second trip to this hospital and first with my family as we enjoyed the hospitality of the locals and helped them medically as they graciously introduced us to their way of life. The predominance of surgeries I performed involved fractures and infections as dangerous roads and driving conditions unfortunately cause a very large amount of significant trauma to the working class. It is extremely important in their culture and economy to get these patients back on their feet to allow them to continue to provide for our family. I had the opportunity to let my family enjoy the trip with me and we were impressed with the beauty of the country and its people. We also had a chance to witness up close the amazing wildlife that has been so well preserved in Kenya – it was a trip of a lifetime for me and my family, though I hope to have the opportunity to go back in the future.”

Check out the pictures from his trip!

photo 4(2)photo 3(2)photo 2(3)photo 1(2)photo-5

 

Dr. Ruhlman and his family are leaving for Kenya this Christmas Eve!

Dr. Ruhlman and his family are leaving for Kenya this Christmas Eve. Dr. Ruhlman served at Tenwick Hospital in Bomet, Kenya last year and he is doing it again. According to Dr. Ruhlman, “The country was quite beautiful and the people are very generous and accommodating. Just about a 4-hour drive out of Nairobi, Tenwick Hospital is a rural 300- bed hospital serving a very large under served area. The hospital employs over 500 local kenyan workers and has significant international support. World Medical Mission supports the hospital with logistics and helping volunteers travel to Tenwick and that is how I got involved to help with their Orthopedic Surgical load.”

Last year, Dr. Ruhlman performed 3-5 surgeries per day working with the resident and attending surgeons and helped teach them techniques that he uses in his practice.

What a great way to pay it forward Dr. Ruhlman! Kudos to you and Happy Holidays to you and your family while you will be in Kenya!
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