The importance of getting an MRI

The importance of What is an MRI (magnetic resonance imaging)?

Written by Fabio Pencle

An MRI or magnetic resonance imaging is a diagnostic test that uses magnetism, radio waves, and a computer to produce images of body structures. A patient is placed on a bed that moves through the circular magnet, creating a strong magnetic field using protons from hydrogen atoms exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. A computer processes the receiver information, which produces an image.

Technology of MRI machine have improved over time and can produce detailed imaging. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the images.

What are the uses for an MRI?

An MRI scan is an accurate method of disease detection throughout the body and is most often used after other testing modalities to provide sufficient information to confirm a patient's diagnosis. An MRI scan is used for defining brain anatomy and evaluating the integrity of the spinal cord after trauma. 

When considering problems associated with the vertebrae or intervertebral discs of the spine and MRI scan detects abnormalities such as herniated disc, spinal stenosis and other abnormalities. An MRI scan can evaluate the structure of the heart and aorta, where it can detect aneurysms or tears. MRI scans are not the first line of imaging test for these issues or in cases of trauma.

It provides valuable information on glands and organs within the abdomen, and accurate information about the structure of the joints, soft tissues, and bones of the body. Often, surgery can be deferred or more accurately directed after knowing the results of an MRI scan.

What are the risks and side effects of an MRI?

An MRI scan is a painless radiology technique that has the advantage of avoiding x-ray radiation exposure. There are no known side effects of an MRI scan. The benefits of an MRI scan relate to its precise accuracy in detecting structural abnormalities of the body. Patients who have any metallic materials within the body must notify their physician prior to the examination or inform the MRI staff. Metallic chips, materials, surgical clips, or foreign material (artificial joints, metallic bone plates, or prosthetic devices, etc.) can significantly distort the images obtained by the MRI scanner. Patients who have heart pacemakers, metal implants, or metal chips or clips in or around the eyeballs cannot be scanned with an MRI because of the risk that the magnet may move the metal in these areas. Similarly, patients with artificial heart valves, metallic ear implants, bullet fragments, and chemotherapy or insulin pumps should not have MRI scanning.

How is the procedure performed?

MRI exams may be performed in an outpatient or inpatient basis.  In the outpatient setting you will be positioned on the moveable exam table. Straps and bolsters may be used to help you stay still and maintain your position.

Some patients can experience a claustrophobic sensation during the procedure. Therefore, patients with any history of claustrophobia should relate this to the practitioner who is requesting the test, as well as the radiology staff. A mild sedative can be given prior to the MRI scan to help alleviate this feeling

MRI exams generally include multiple runs (sequences), some of which may last several minutes. You will be placed into the magnet of the MRI unit. The technologist will perform the exam while working at a computer outside of the room.

If a contrast material is used during the exam, it will be injected into the intravenous line (IV) after an initial series of scans. More images will be taken during or following the injection.

When the exam is complete, you may be asked to wait while the radiologist checks the images in case more are needed. Your IV line will be removed after the exam is over.

Depending on the type of exam and the equipment used, the entire exam is usually completed in 30 to 60 minutes.

Why is an MRI important?

This high-tech test is key to diagnosing and treating many health conditions that would otherwise remain hidden. While digital X-rays produce two-dimensional images, Magnetic Resonance Imaging renders three-dimensional images or even slices of internal organs.

This precision allows the doctors to gather and give information on health conditions such as:

·       Herniated Disc

·       Spinal Stenosis

·       Facet tropism

·       Multiple sclerosis

·       Tumors

·       Aneurysms (defects in artery walls)

·       Pinched nerves

·       Syrinx (fluid within the brain stem or spinal cord)

·       Congenital malformations

·       Stroke

·       Seizure disorders

·       Chiari malformation and associated balance problems

·       Head trauma

·       Bone infections

·       Problems with the inner ear and eye

Fortunately, an MRI is painless and non-invasive as it simply uses a strong magnetic field and radio waves to produce its remarkable “pictures.”

Building from the ground up, we strive to be a global outpatient Academic Orthopedic and Neurosurgery-Spine Specialty & Research Institute of Excellence. We aim to lead in Less Exposure Surgery techniques. For more information call 855-411-LESS.

What to Expect for Outpatient Surgery?

What to Expect for Outpatient Surgery?

Fabio Pencle, MBBS; Kingsley Chin, MD

The Consult Visit

When you are diagnosed by your primary care provider with a condition that requires surgery, they should send you to the surgical specialist for further investigation. Surgery is a treatment option for injuries or disorders of the body by incision or manipulation, especially with instruments.

During a consult visit, your surgeon will perform an examination and ask more questions. They will explain their findings and recommendations to you. They may recommend outpatient surgery, often a procedure that lets you go home at the end of the day.

Surgical Education

Our surgical team consist of a surgeon who makes the recommendation and advises the patient about the procedure. Most patients still have questions and we provide a dedicated education class to allow discussion and questions from the patient to be answered. Our trained surgical concierge educator and team provides additional support to the patients and help to coordinate preoperative and postoperative follow up.

Clearance & Preoperative Visits

Once your procedure has been scheduled, you will receive further instructions on clearance and a pre-operative visit will be needed. The Anesthesiologist is a medical specialist responsible for sedation, 'putting you to sleep', and pain control after surgery he will see you prior to surgery.

The Week Before Surgery

In the days before surgery your doctors will recommend that some medications be avoided as they might interfere with healing or anesthesia. Some examples are aspirin and anti-inflammatory drugs such as Motrin, Advil, Excedrin and ibuprofen. Also reduce or stop smoking in the week before surgery.

Night Before Surgery

Eat a light dinner in the late afternoon. Avoid alcohol 24 hours before surgery. Ask your provider if you should take your regular medications. The use of illicit drugs will prevent surgery from being performed.

After midnight, do NOT eat any food including gum, candy, breath mints, or cough drops. Also do NOT drink anything - water, coffee, juice, etc. Do NOT swallow any of the water that is used to brush your teeth.

If you accidentally consume food or water tell your provider as doing so could be dangerous and the surgery may have to be postponed. For your safety, surgery must be done on an empty stomach. Also, if you begin to feel sick or develop a fever call your provider.

These are very general instructions, so ask your MD, as instructions vary with treatment.

Day of surgery

For outpatient procedures, patients should be at the facility at least one hour before their surgery's scheduled time. A staff member will check you in and take you to the waiting area before your surgery. There you will change into a hospital gown.

If you wear glasses, contacts, and/or hearing aids they will need to be removed.

A staff member will come to check your blood pressure, pulse and temperature. Your anesthesiologist will come to talk to you about how you will be sedated, 'put to sleep', and cared for after surgery.

Shortly thereafter, you will be sedated and brought into the operating room for your procedure. If you have any questions feel free to ask them at any time. Our medical staff want to know about your concerns.

Remember to bring with you:

·       Someone to take you home

·       Your insurance card

·       A change of comfortable clothes

·       A case or holder for glasses, contacts, dentures or hearing aids (if you wear them)

·       Sometimes there might be some waiting involved so you might want to bring a book

 Do not Bring:

 ·       Do not bring valuables - jewelry, credit cards or more money than necessary to fill any prescriptions

·       Do not wear make-up and make sure nail polish is removed

·       Do not use lotions, creams, or aftershave, and do not wear perfume.

·       Do not use hairspray, mousse, or gels.

·       Do not shave or use deodorants near the site of surgery

·       Take off all body piercings

During Surgery for Friends and Family

We know that your surgery can be an anxious time for your friends and family who accompany you to your procedure. Our staff will keep them informed as to your progress while they wait in the waiting room.

After Outpatient Surgery

After your surgery you will be taken to the recovery room. You will be monitored and given time to recover. The length of time will depend upon the type of surgery you had. When it is time to leave, a staff member will go over instructions on how to take care of yourself at home. You may also be given prescriptions that you will need to have filled. If you need some extra help a staff member can help you to your car.

You should take it easy the next few days after surgery. Do not drive or operate machinery the day after surgery. If you have questions, please ask your provider.

You may be tired and feel discomfort after surgery. This is to be expected. Your provider will give you something to ease the pain or discomfort. If you are in pain, have a fever, or drainage and/or pus from where you had surgery, call your provider right away. If you have any acute concerns, call 911 or have someone drive you to the closest emergency room.

Be sure to keep all post-surgery appointments that you have with your surgeon. Call your provider's office for any questions that you might have.

The LESS Institute uses a new philosophy of Less Exposure Surgery (LES), utilizing the least invasive techniques and technologies to achieve the best and most efficient outcomes so patients can return immediately to an active lifestyle. As LESS Institute Founder, Dr. Kingsley Chin, board certified spine surgeon, pursues endeavors of medical entrepreneurship, tourism & mentorship throughout Florida, New Jersey, New York, Arizona & Jamaica, treating thousands of patients globally each year. For more information or to get in touch with our team visit www.thelessinstitute.com or call 855-411-LESS.

What should I know before a Surgical evaluation: Goals, Expectations and Concerns

Written by Fabio Pencle

Overview

Surgery is a branch of medicine that deals with the treatment, management, and assessment of a wide range of medical conditions. It is the treatment of injuries or disorders of the body by incision or manipulation, especially with instruments.

A surgery consultation is the first step towards understanding your diagnosis and asking relevant questions you may have. It is an essential part for both your surgeon and you. During the consultation a clinical assessment involves the surgeon asking about your complaint (History) and performing an examination (Physical) to determine your diagnosis. Based on this diagnosis a surgical recommendation is made by the surgeon and any further questions can be answered about the procedure, benefits and risks. At this time if the you agree to surgery, you may be consented to have a record of the type of procedure and a tentative date scheduled.

Our practice offers further follow up with a concierge service. Further education classes and logistics for surgery schedule is coordinated for you.

According to the data of Centers for Disease Control and Prevention (CDC), approximately 22.5 million surgeries are performed in ambulatory surgery centers every year.

Goals of Surgery

• Ensure the patient is not subjected to unnecessary pain, discomfort, and recovery process

• Suggest the most suitable surgical technique or procedure to treat the disease, reduce the symptoms, or manage the condition

• Make the patient fully understand the potential risks or complications of the procedure

• Outline an individualized surgical plan that can be followed through

• Keep track of the patient’s progress and recovery, especially during the first 24 to 48 hours after the surgical procedure

Expectations and Fears

Patients go through surgery consultation when they are referred by their primary care provider (PCP) or other specialists

Are meant for surgery? If the surgeons determine the patients are likely candidates for surgery, they conduct more consultations wherein they perform or interpret test results, plan the surgical procedure (including the date of the surgery), recovery program, etc.

What occurs when surgery is complete? Consultations are also carried out as soon as the surgery has been completed. At this point, the surgeon’s concern is to ensure that the patient responded well to the procedure and to verify whether there are complications.

What happens if there is a complication? Not all surgical complications occur quickly. In some cases, it takes days or even years for them to be discovered. Patients who develop such are encouraged to set an appointment with their surgeon, so the complications are addressed as soon as possible, preventing them from getting worse.

The expected results of the surgery depend on the goal of the consultation. The patients may:

• Learn whether they are fit for surgery or, if not, understand the reasons why and determine other possible treatment options

• Identify the risks and possible results of the surgery so they can decide for themselves whether to proceed with it or not. In the case of minors (pediatrics), the decision rests with the adult, who is either a parent or a guardian.

• Obtain a better picture and prognosis of the disease based on the additional tests

• Ensure patients are prepared physically, mentally, and even spiritually for the surgery

• Determine the best steps to take during the post-operative care

How Does the Procedure Work?

Most of the surgical consultations are planned. This means the patient has been referred by a doctor or a specialist following the results of initial tests. Patients then set appointments with the recommended or their chosen surgeon.

During the initial pre-operative consultation, the surgeon asks a series of questions to know the main concern of the patient, from the disease to the fears or discomfort about surgeries. The surgeon then reviews the results of the exams, which should have been forwarded before the consultation. If the tests are not enough to decide, the surgeon may request for more tests, which will then be evaluated and discussed during the next consultation.

Possible Risks and Complications

A surgery consultation doesn’t in any way guarantee the elimination of risks and complications. However, one of the primary objectives of the consultation is to reduce and/or mitigate these risks, which can include bleeding, infection, and organ failure. Patients and surgeons should work hand in hand to ensure the patient’s safety all throughout the surgical process.

Building from the ground up, we strive to be a global outpatient Academic Orthopedic and Neurosurgery-Spine Specialty & Research Institute of Excellence. We aim to lead in Less Exposure Surgery techniques. For questions and scheduling call 855-411-LESS.

Good news for the 31 million Americans with lower back pain: These lifestyle habits can bring relief and help you avoid future problems.

Sometimes all it takes is bending over to pick up a pen from the floor for pain to strike. Fortunately, most of the time back pain is short term and goes away on its own. But if you experience chronic back pain, you may benefit from making certain everyday adjustments.

In fact, lifestyle has the biggest influence on back pain, and healthy habits such as a good diet, exercising, stretching, and posture can give you back pain relief or help you prevent future problems.

Make these steps part of your back pain treatment plan:

Maintain a healthy weight. Staying fit is one of the most important recommendations for avoiding back pain, says Kingsley R. Chin MD, spine surgeon and founder of The LESS Institute. Extra pounds stress your back and can cause pain. Eating a healthy diet filled with fruits and vegetables and low on processed foods can keep your weight in a healthy range and your back healthy.

Keep your back muscles strong. The most common back problems happen because people who aren't in shape start doing heavy lifting or hard work and stress their back, Dr. Kingsley Chin says. Back pain usually happens when there's degeneration of the spine because the spine is working too hard. But when you build up enough muscle strength in your back with exercise, the muscles give your spine the support it needs to keep it healthy. That's why physical therapy is standard back pain treatment, but being in shape can help you avoid back pain to begin with.

Stretch your muscles. In addition to exercise, stretching is important for staying flexible and avoiding back problems. It's also a key part of recovering from a back injury. Stretch before doing heavy lifting or exercise and make a habit of doing it before bed. Stretches can be as simple as bending forward, bending back, and bending side to side. The ultimate stretching exercise is yoga.

Focus on good posture. Poor posture is another major contributor of back pain. Standing up straight with your ears over your shoulders, your shoulders over your hip joints, and your hip joints over your ankles will help keep your healthy pain-free. When you're sitting, getting a chair that's designed to keep your back straight will help.

Lift properly. When you do pick up a heavy object, bend at the knees and keep the item close to your body. Also, take care not to twist your body when you lift, and wear a brace if you have a job that requires heavy lifting.

Leave your purse at home. If you can, stash a few dollars and your identification in your pocket when you leave the house rather than carrying around a heavy purse. Carrying a bag changes your balance and can change the curve of your spine. Even a wallet packed full of cards and receipts in your back pocket can affect your back because it puts pressure on your sciatic nerve.

Practice stress relief for back pain relief. Stress tends to make back pain worse. That may be another good reason to practice yoga. Other ways to reduce stress include treating yourself well, avoiding over-scheduling your days, and taking time to enjoy life.

Sleep well. Soft mattresses push your back out of alignment, so it's best to choose a mattress that's in the range of medium to firm for back pain relief.

Living a healthy lifestyle that's full of exercise and taking some care to have a healthy back can help you live free of chronic back pain. If pain persists it’s time to make an appointment with your orthopedic doctor.

We at the LESS Institute are available to answer any questions or inquiries and we offer free MRI review. 

The LESS Institute is the world leader center of excellence in Less Exposure Surgery.  You deserve the best and at The LESS Institute, we focus on identifying the problem and performing effective treatments with minimal blood loss so that patients can recover quickly, avoid expensive hospital stays and return home to their family the same day.  The LESS Institute specializes in the best and most efficient least invasive techniques and technologies available.  As LESS Institute Founder, Dr. Kingsley Chin is a board-certified Orthopedic Spine surgeon who has been treating of patients throughout Florida, New Jersey, New York, Arizona & Jamaica each year. For more information or to get in touch with our team visit www.thelessinstitute.com or call 855-411-LESS.

Setting Your New Years Resolution- & Keeping It

Content by Esther Rodriguez & Ana Williams

As we ring in the new year, we inevitably ring in resolutions to follow – from fitness aspirations to lifestyle improvements, we all share a common end goal: to improve our lives in the upcoming year, by altering bad habits and fostering positive ones. But goal setting is more than making a wish and hoping it will come true. It’s about making it happen and sticking to it. This year, don’t promise the same old new year’s resolution just to find yourself given up by February. The biggest mistake we see are goals that are too broad, too big or too complex. Read on for your guide to setting a manageable new year’s resolution – and keeping it for good.

TIP #1: RECOGNIZE WHAT YOU NEED TO CHANGE.

Take a serious step back and consider what you feel you need or want more out of life. It could be as major as a big move, or as “minor” as dedicating more time to home cooking. Whatever will increase YOUR quality of life – make it happen.

TIP #2: ESTABLISH SMART GOALS.

S.M.A.R.T. goals are those that are specific, measurable, attainable, relevant and time-based. Set these goals by writing them down, making them feel tangible. Then plan the steps you must take to realize that goal, and cross each off as you work through.

TIP #3: BEGIN A GOAL-DIRECTED ACTIVITY.

The first step to achieving your goals is starting. Don’t let the prospect of hard work keep you from beginning. It takes just one step – and voila! You’ve begun.

TIP #4: TRACK YOUR PROGRESS.

Tracking your progress doesn’t have to be intimidating, but it does need to hold you accountable. Whether it’s in baby steps or giant leaps, track your wins every time. This will serve as both proof of achievement and a motivator to keep you climbing for success.

TIP #5: REWARD YOURSELF.*

Perhaps the best step of all: reward. Don’t forget to celebrate your wins, even if it’s in a small way. You ran a mile every day last week? Highlight that by treating yourself to a new piece of gym swag. Or take a day off and pick back up twice as hard the following. Small wins are still wins.

*Just don’t go too easy on yourself! Goals are meant to challenge and better you – and hard work is tough for a reason. The easy path won’t get you to your desired destination, trust us. It’s all about a happy medium in rest & reward. You know your limits; establish those, stick to them & you’ll thrive.

Share below how YOU make & keep your new year’s resolution. How will you take 2020 by the horns?

Adding Vitamins and Minerals to Your Diet to Promote Back Health

By Abagail Sullivan

You may never have considered diet as a way to promote back health, but what you eat is most certainly an influence in whether or not your back is feeling up to par. Consuming enough nutrition – through back-health promoting vitamins and minerals – is crucial in the development, maintenance, and improvement of your bone, muscle, and disc health. Review this list of vitamins and minerals – whose back relief benefits we’ve highlighted – and find out where you can access these (easy, healthy recipes linked accordingly) to start promoting your best back, today!

Vitamin A

Vitamin A helps repair tissue and aids in the formation of bone.

Examples of sources high in vitamin A include: beef liver, carrots, sweet potato, kale, spinach, broccoli

To note: more than the recommended amount of vitamin A (about 900 mg daily for men and 700 mg daily for women) can promote bone fractures, so beware of excess intake.

Vitamin B3 (Niacin)

Vitamin B3, also referred to as Niacin, can help maintain a healthy nervous system, which is important for many spine conditions.

Good sources: turkey, chicken breast, peanuts, mushrooms, lamb liver, tuna

Vitamin B12

Vitamin B12 is crucial for healthy bone marrow and for the spine to grow and function.

It reduces pressure in your back and eases chronic back pain.

Good sources: clams, beef liver, mackerel, crab, tofu, bran cereal

Vitamin C

Vitamin C is necessary for the development of collagen, which allows cells to be able to form into tissue.

It is important in the healing process for injuries involving tendons, ligaments, discs, bones, wounds, and burns.

It increases calcium absorption in the body to promote strong bones and protects your back from damaging free radicals.

Good sources: oranges, red peppers, kale, brussels sprouts, broccoli, strawberries

Vitamin D

Vitamin D is important for the development of healthy bones, aiding in calcium absorption to help prevent osteoporosis.

It produces new bone cells, decreases inflammation in the body, and can lessen spasms in the lower back.

Good sources: sunlight, sardines, salmon, mackerel, tuna, soy milk

Vitamin E

Vitamin E can help alleviate lower back pain as a powerful antioxidant that fights off free radicals.

It increases the antioxidant reaction in your body and reduces muscle pain and soreness by repairing damaged tissue.

Good sources: almonds, spinach, sweet potato, avocado, wheat germ, sunflower seeds

Vitamin K

Vitamin K is needed for the bones to properly use calcium, which in turn aids in the strength of healthy bones.

Good sources: dried basil, kale, onions, brussels sprouts, chili powder, asparagus

Calcium

Calcium is essential for bone health and building strong bones, helping to maintain the necessary level of bone mass and prevent osteoporosis.

Good sources: watercress, mozzarella, milk, yogurt, bok choy, tofu

Iron

Iron aids in the production of myoglobin, an important element of healthy muscles needed to support the spine.

Good sources: squash and pumpkin seeds, chicken liver, oysters, mussels, clams, nuts

Magnesium

Magnesium helps maintain muscle tone and bone density, which can aid in the prevention of back problems.

It is also a factor in prevention of calcium deficiency and osteoporosis.

Good sources: raw spinach, squash and pumpkin seeds, mackerel, soy beans, brown rice, avocado

Omega-3 fatty acids

Omega-3 fatty acids can help inflammation that cause back pain.

Good sources: cold pressed flaxseed oil, salmon, chia seeds, walnuts, caviar, mackerel

Other sources that could be helpful…

Devil’s Claw

Devil’s Claw comes from a native African plant and can reduce flare-ups of chronic low back pain.

The ingredients in this plant may be effective in reducing back pain, because it’s chemicals may decrease inflammation and swelling that cause the pain

Capsaicin

Capsaicin is the agent that gives hot peppers their heat, and this ingredient can be applied, using a cream, to relieve back pain.

Turmeric

Taken as a powder in capsules, mixed into tea, or as a liquid extract, Turmeric contains effective anti-inflammatory properties.