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<HTML><PRE>Dr. Carl Goodman 01-17-97 Orthopedics Columbia/HCA hosts a series of weekly, interactive chats between physicians and consumers. Columbia is the nations largest provider of healthcare services with over 340 hospitals, 180 home health agencies and more than 125 outpatient surgery centers in 36 states, England, and Switzerland. DrColumbia: Thank you H 4 Col: Columbia host a series of chats between physicians and consumers. H 4 Col: Columbia is the nations largest provider of healthcare with more than 350 hospitals. A1Akeys: I have a question about the drug, EFFEXOR H 4 Col: 400 homehealth care agencies, and more than 130 outpatient surgery centers. DrColumbia: I am not familiar with the drug. H 4 Col: tonight we are joined by doctor Charles Goodman, a orthopedic surgeon affilitated with H 4 Col: columbia Highland Hospital. A1Akeys: EFFEXOR is an antidepressent H 4 Col: If you have a question about orthopedics or more specific Orthopedic Surgery, Microscopic H 4 Col: surgery for low back pains please feel free to ask. DrColumbia: Dr. Goodman's first name is Carl not Charles H 4 Col: Dr. Carl Goodman. H 4 Col: If you are ready doctor shall we begin? DrColumbia: Yes H 4 Col: The doctor will only be able to talk to one person at a time H 4 Col: Please ask your question and wait for the doctor to address you. H 4 Col: If you have a question please feel free to ask. Riddler447: what is carpal tunnel syndrome,the cause and the cure DrColumbia: Carpal tunnel syndrome refers to a pinched nerve in the wrist and not related to the spine H 4 Col: Doctor, how does posture play a role in spine problems? TBABE947: is this room just for doctors? H 4 Col: This room is for consumers to ask questions of doctor. DrColumbia: A big factor is proper posture for treatment and prevention of back problems DrColumbia: Chest out posturing i.e. just holding your chest up puts you in proper posture TBABE947: thank you H4, does anyone know anything about dystonia? DrColumbia: It is a Neuromuscular Disease and not in my field of expertise H 4 Col: I have never heard of it. H 4 Col: Dr. Goodman do you have a general idea of what it is? DrColumbia: Yes, but I would rather not discuss it. Thank you. TBABE947: your right doctor, and thank you for being so honest with your respond, what is your field? H 4 Col: Could you tell us a little about your practice? DrColumbia: Orthopedic Spine Surgeon H 4 Col: What is the biggest advancement you have seen in the last ten years concering spine DrColumbia: I see patients with neck and lower back problems and offer treatment in the form of H 4 Col: surgery? TBABE947: i will respect DrColumbia, but if there is someone else that would like to discuss it we can DrColumbia: non-operative care and microscopic surgery. H 4 Col: Do you think that those with severed spine will be able to walk in the next 20 years? TBABE947: hello it's only us three in the room and DrColumbia i giving you your repect but why won't TBABE947: you seak on dystonia DrColumbia: Perhaps DrColumbia: Because I don't know enough about it. Darylmars: Hello TBABE947: i mean speak about dystonia, you know it effects the back also TBABE947: there is always room for knowledge TBABE947: Iparish, hello what is your topic DrColumbia: A Internal Medicine Specialists, Neurologist or Rheumatologist is qualified to address this Iparish: I DON'T HAVE A TOPIC, JUST IN ROOM TO SEE IF I HAVE ANY INTERESTS IN WHAT'S GOING ON TBABE947: thats true and i agree, but i thought that being a doctor you may come by a person with this Iparish: with what? TBABE947: Iparish you can lower your voice, just by hitting the cap key DrColumbia: I'm sorry I cannot help you with the subject dystonia. TBABE947: DrColumbia don't get me wrong i was not asking for help just wanted to chat Iparish: Excuse me, TBABE947 JMury580: Dr. is your orthopedic practice limited to spine surgery? TBABE947: sure you can be excused DrColumbia: Yes H 4 Col: None of the information Dr. Goodman answers to should be considered a diagnoses TBABE947: i see we have 6 people here know is there any other topics H 4 Col: We are talking Orthopedic Surgery. H 4 Col: If you have a question about Orthopedic Surgery for DrColumbia please feel free to ask. TBABE947: and 2 more makes 8, let's chat people Rhkch: Should bunion surgery be performed by an orthopod or a podiatrist? DrColumbia: An Orthopedic Surgeon TBABE947: good answer Rhkch: Could you please explain the precedure, recovery time etc.? Darylmars: Dr.what can be done for lower back pain ivolving the siatic nerve. TBABE947: good question my mother has the same question Erica96835: mine too. DrColumbia: Bedrest 24 to 48 hours, Anti-inflammatory drugs, asprin etc. Erica96835: What can be done for leg and foot pain? Darylmars: It goes out on me from time to time DrColumbia: exercise therapy and sometimes cortisone by pills or injections for lower back problems DrColumbia: Same treatment for leg pain TBABE947: thank you doctor i will relay that to my mother Darylmars: sometimes just sitting or moveing just right DrColumbia: right JMury580: Dr. how do you like working in a Columbia hospital? Darylmars: Dr. were do they give the injection of Cortisone Erica96835: Will massage and muscle rub also help to ease leg pain? TBABE947: Dr was the right directed to me? i'm sorry if i have made you upset DrColumbia: I like it very much Erica96835: It seems to be worse for my mom at night. DrColumbia: Cortisone injections are usually just given intramuscularly in the buttock. H 4 Col: Tonight we have Dr. Carl Goodman here to answer your question about Orthopedic Spine H 4 Col: Surgery. H 4 Col: If you have a question please feel free to ask. Erica96835: She hurt her leg after all the walking we did for the holidays. TBABE947: who's mother mine or Erica's DrColumbia: How old is TBABE947 mother? TBABE947: my mother is 54 DrColumbia: You should take your mother in to see a physician DrColumbia: Erica I don't treat leg injuries. Darylmars: Will compresed disks heal on their own Erica96835: She made an appointment with her physician for next Tues. thanks for your advice. DrColumbia: Yes -- 90% of disc injuries heal by themselves if given 3 to 6 months Darylmars: Thankyou Dr. Goodman Topcat0909: Dr. G-I had a fusion for a herniated disk at C5-6 and 6-7 in January 1995. It collapsed and Topcat0909: I had a redo in November of 1995. I still suffer from shooting pain down my arm, burning at Topcat0909: the back of my neck and general pain. Could this be Arachnoiditis? DrColumbia: Yes it could be TBABE947: thank you DrC for putting up with me, this is my first visit here,each room is diffrent bye Topcat0909: 3 orthopedists and 3 neurologist have said it is scar tissue and radiculopathy. Will this Topcat0909: ever go away? I am on Neurontin, Prozac and Ultram. DrColumbia: I don't have a good answer for you, but probably not H 4 Col: If you have a question about orthopedic surgery please feel free to ask. Topcat0909: Is there a test to positively diagnose Arachnoiditis? DrColumbia: Myelogram, CT Scan or MRI may be helpful Darylmars: I have to go now so thanks for again for the help Dr.Goodman Topcat0909: I had an MRI to see if my fusion had collapsed in August. Even though they weren't looking DrColumbia: Goodbye Darylmars: Thanks H 4 Col ,goodnight Topcat0909: for Arachnoiditis, can they tell from that film if I have it reviewed again? DrColumbia: Possibly Topcat0909: Should I have a radiologist, neurologist or orthopedist look at it? DrColumbia: Start with a Radiologist, from there the choice is yours Topcat0909: Also, I have heard that the combination of Prozac and Ultram can cause seizures. Are you Topcat0909: familiar with this? DrColumbia: No Topcat0909: My original injury was caused by a chiropractor. I went to her with a stiff neck and she did Topcat0909: no X-rays. Just started adjusting and she herniated a disk in my neck, OUCH. Topcat0909: It took 3 doctors 3 weeks to diagnose the injury. During that time, I think the disk rubbed Topcat0909: against a nerve and did permanent damage. Because it has never felt right. CRS0609: Hello room-who's here Topcat0909: Does nerve damage heal? DrColumbia: Sometimes nerve damage will heal Topcat0909: Is there anything I can do to promote and speed up the healing process? H 4 Col: tonight we are talking about orthopedic surgery. DrColumbia: Drugs such as Elavil will relieve nerve symptoms while healing occurs CRS0609: Is anyone familiar with pediatric orthopedics DrColumbia: No Topcat0909: I took Elavil for awhile - it upset my stomach so I was switched to Prozac. Is this OK? DrColumbia: Prozac is an antidepressant and doesn't affect nerve pain Topcat0909: What is Elavil? DrColumbia: It is amyltryptoline Topcat0909: Speak English please. Topcat0909: (English for the non-medical population) DrColumbia: That's all I know about the medication. Look it up in the PDR Topcat0909: OK I will. But I tried looking up Ultram and there was nothing on it. Thanks for your time. DrColumbia: You are welcome H 4 Col: Thank you for coming online tonight Dr. Goodman. Topcat0909: I forgot to ask you. Is it always necessary to remove hardware from the lumbar region Topcat0909: after a fusion. DrColumbia: No unless it is causing a problem that can be identified Topcat0909: OK...thanks again. I'm sorry there aren't more people on line with you tonight. H 4 Col: Dr. Goodman, thank you for coming online tonight. H 4 Col: I think that many people have had trouble signing on. DrColumbia: You are probably right H 4 Col: You have been wonderful and you must be ready for dinnerl. DrColumbia: Yes, Tubell: i have a question after surgery how long before start ther ex H 4 Col: This ends tonight chat with Dr. Goodman. H 4 Col: copyright columbia 1997. H 4 Col: Goodnight Dr. Goodman. DrColumbia: I usually have my surgical patients start walking the next day DrColumbia: Goodnight. Tubell: ok thanks H 4 Col: goodnight. Copyright Columbia 1997 </PRE></HTML>