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July 31, 2020

As seen in Southbury's HamletHub

Last week, The New York Times published an article about the uptick in solitary leisure focusing on Ridgefield and Darien Running Company and founder, Megan Searfoss.

With gyms closed for several months, running has picked up even more fans and exercise enthusiasts. If you’re one of them, take note of some common foot and ankle problems that may result from lacing up your sneakers and pounding the pavement for several miles.

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Concerned about the impact a new running regimen may have? OrthoConnecticut’s Foot and Ankle Surgeon, Dr. Randolph Sealey, who is well versed in nonoperative as well as surgical management for foot and ankle problems, and OrthoConnecticut’s Podiatrist, Dr. Thomas Guglielmo answer some common questions posed by runners.

Dr Sealey ped LR 1002 72dpi 640x512Dr. Randolph Sealey with patient.Q:  I run through my pain? How do I know if I need to see a doctor?

A: Dr. Sealey:  As long as your running or walking mechanics are normal, and you can complete your usual distances, then you can continue running or walking through some pain. Another indication that running or walking through pain may not be problematic is that you are able to return to your next scheduled run at your normal timeline. Warning signs that you may need to see a doctor include abnormal running mechanics, limping, not being able to accomplish usual running distances, swelling and not being able to return to running despite rest, ice, compression and elevation. Do seek an evaluation by a specialty trained foot and ankle specialist should pain persist.

Q: Can orthotics help with my foot pain? 

A:  Dr. Guglielmo: Once the cause of the pain is diagnosed, then an orthotic can be utilized to protect or support the injured area. I use a multitude of different materials to make orthotics depending on what condition we are trying to correct or accommodate. Softer materials are used to reduce pressure and absorb shock while more rigid materials help to stabilize and provide support. 

Q:  Can I buy orthotics over the counter?

A: Dr. Sealey: As long as the foot alignment is not severe, then an over-the-counter orthotic is always my first recommendation.  If the runner over supinates, it may be difficult to obtain an appropriate orthotic because most over-the-counter orthotics are made for pronators. If you have tried over-the-counter orthotics and your pain continues, this is an indication that you may need to see a doctor for a custom orthotic insert. 

Q: Will a cortisone shot work?

A:  Dr. Sealey: Cortisone can play a role in the resolution of foot pain, however, it is important that it is not the first option used to solve the problem.  It is important to realize that cortisone readily treats an inflammatory problem and not a structural problem. Sometimes cortisone injections can cause more damage when they are used to treat a structural problem in a foot and ankle.

Q: Do you recommend any certain brand of sneaker?

A: Dr. Guglielmo: Most of the popular well-known brands of sneakers make different styles of shoes depending on your particular foot type. An individual with a high arch usually does best with a wider, softer shoe versus the individual with a flexible flatfoot --they do best in a motion control supportive shoe. I recommend they go to a running specialty store to be fitted with the proper shoe for their particular foot type. The brand is less important than the style. There are many excellent OTC arch supports available for under $75; the Powerstep and Superfeet brands are two that I often recommend. 

Q: What about braces? 

A: Dr. Guglielmo: I use off the shelf braces to stabilize the foot and ankle and limit motion. These devices reduce strain on the ligaments, tendons and joints to facilitate healing from acute injuries. Chronic long standing conditions often benefit from custom-made braces especially when surgery is not an option or when significant deformity is present. Custom braces are sometimes needed to correct foot and ankle deformities. An off-the-shelf brace is often not strong enough to address certain problems (ankle instability, posterior tibial tendon insufficiency). 

Q: When is surgery recommended? 

A: Dr. Sealey: Surgery is recommended when there is major structural injury to the bones, ligaments or tendons of the foot and ankle that will not heal on their own with rest. When an individual has significant functional disability, surgery may be the only option to correct the problem. If your pain does not significantly improve despite rest, ice, compression and elevation after a period of 4 to 6 weeks, then a specialty focused foot and ankle evaluation is recommended.

Dr. Randolph Sealey, is a board-certified, fellowship trained Foot & Ankle surgeon specializing in surgical and non-surgical care of the foot and ankle. Dr. Sealey has extensive training, ranging from simple hammer toe and bunion correction, to complex tendon and deformity correction. He sees patients in OrthoConnecticut’s Danbury and Southbury locations. More information on Dr. Sealey is available at https://myorthoct.com/randolph-sealey-m-d.

Dr. Thomas Guglielmo, is a board-certified Podiatrist specializing in medical and surgical foot care for adults and children. He sees patients in OrthoConnecticut’s New Milford and Litchfield offices. For more information on Dr. Guglielmo, visit https://myorthoct.com/thomas-g-guglielmo-d-p-m.

To learn more about foot and ankle care or to schedule an appointment for an evaluation, please call the OrthoConnecticut office at 1-833-ORTHOCT (1.833.678.4628) or visit the website myorthoct.com.

July 23, 2020

OrthoConnecticut surgeons announce they are now using Stryker’s Mako SmartRobotics system for Total Hip, Total Knee and Partial Knee replacement surgery at their outpatient center, Western Connecticut Orthopedic Surgical Center (WCOSC) in Danbury. Now, to assist doctors with joint replacement procedures and provide greater accuracy, patients scheduled for same-day or single overnight surgery at the outpatient surgical center will be able to benefit from the Mako SmartRobotics technology.

“We are thrilled to have this state-of-the-art robotic technology available at our local outpatient surgical center,” says OrthoConnecticut Total Joint Specialist, Dr. Robert Deveney. “At WCOSC, we are now able to offer our patients the most advanced surgical technique supported by the finest robotic technology on an outpatient basis or for single night stays.”IMG 3458 web optimized

The robotic-arm system enables doctors to create patient-specific surgical plans allowing for increased accuracy in implant placement for the best outcome and reduced pain in each case. The advanced system combines three key components: 3D CT-based planning, AccuStop haptic technology, and insightful data analytics, into one tool that has shown better outcomes for patients needing total hip, total knee, and partial knee procedures. In the past, surgery plans were created using two-dimensional Xrays. With the adoption of the Mako system at WCOSC, 3D imaging that delivers accurate and precise information on the exact size and position for a new prosthetic is now more accessible than ever.

Surgeons using this tool observe significant patient benefits:

  • reduced risk of inequality among joints on each side of the body
  • better and earlier range of motion as they return to activity
  • reduced pain following the procedure and during recovery

The Mako Total Hip Replacement is an advanced treatment option that enables highly accurate implant placement, which can reduce the risk for complications. The Mako Total Knee application is an option for patients with pain caused by joint degeneration due to osteoarthritis. The Mako Partial Knee Resurfacing is an alternative procedure to total knee replacement and is for patients with pain that has not affected their entire knee. It is minimally invasive, ensuring minimal effect on the bone and surrounding tissues.

“The most important advantage of Mako SmartRobotics is the increased accuracy in implant placement. This should lead to better outcomes such as fewer hip dislocations, increased stability, better balanced knee procedures that feel ‘more normal’ to patients, and more accurate surgical plan execution,” says OrthoConnecticut Total Joint Specialist, Dr. John Dunleavy. “We believe this technology is the future of joint replacement and will likely become the standard of care in the future,” continues Dr. Dunleavy.

OrthoConnecticut has been the area’s top multispecialty orthopedic practice for more than 60 years and strives to provide patients with exceptional orthopedic care utilizing state-of-the-art techniques.  Offices in 6 convenient locations (Danbury, New Milford, Litchfield, Ridgefield, Southbury and Sharon) offer comprehensive diagnostics, treatment, surgical and non-surgical care for the full range of musculoskeletal issues. For more information, to learn more about robotic-assisted surgery, or to schedule an appointment, visit https//www.myorthoct.com or call 203.797.1500.

June 17, 2020

As seen in Patient StoriesRehabRVNAhealth NewsSpotlight

Terri Alexander prior to surgery discussing the stairs at her Home Safety Evaluation with RVNAhhealths Joe Naber OTAbove: Terri Alexander prior to surgery discussing the stairs at her Home Safety Evaluation with RVNAhhealths Joe Naber OT

It was late March, and Terri Alexander was ready. Ready to be done with the pain, the sleepless nights, and mostly ready to get back to being herself again. It was time for her surgery.   

But then, it wasn’t time.  The Coronavirus pandemic had taken hold in the United States and elective surgeries such as Terri’s total hip replacement were all being postponed. The news came on the day prior to her pre-op appointment.  “I entirely understood the reasoning, of course,” says the long-time Danbury resident, “but it was still extremely disappointing. I had finally decided to take action and was looking forward to being “myself” again. It was a major letdown.” 

The pain and discomfort were getting old. A few years prior, still only in her mid-50s, Terri had started feeling progressive pain on her left side.  “At first I thought it was sciatica or perhaps too much running, as I was not normally a runner but had recently added it to my workouts,” she explains. But it didn’t go away. Instead, it got worse.

Finally, after a European vacation with her family last autumn, in which Terri painfully struggled to keep up walking through capital cities, Terri’s daughter implored her to do something. “It had become unbearable,” says Terri. “That’s when I went to Dr. Deveney [of OrthoConnecticut].”

Terri-Alexander-reviewing-exercises-with-RVNAhealth-Occupational-Therapist-Joe-NaberAbove: Terri Alexander reviewing exercises with RVNA health Occupational Therapist Joe Naber“Often our first course of action is to provide non-operative solutions to ease a patient’s pain,” explains Dr. Deveney, “Terri was already to the point that surgery was her best option in order to get back to doing what she loved. Unfortunately, COVID hit and we had to delay her surgery. I thoroughly understand and appreciate her frustration. She was ready to be back in action. So was I!”

Had Terri’s surgery taken place prior to the #StayatHome order, Terri could have used the lockdown to recover her strength and mobility at home and be raring for the gym when it re-opens later this month. As it was, she did her best to stay strong for her surgery — and her sanity. “I tried to maintain a workout schedule of sorts, as prior to lockdown, I was definitely a “gym rat” working out vigorously six days a week. It was difficult though because as the pain progressed, I was unable to do any sort of meaningful cardio, mainly weight/strength training.” 

When the State of Connecticut approved the return of outpatient elective surgeries, Terri was one of the first in line. Her total hip replacement was performed at the Western Connecticut Orthopedic Surgical Center in Danbury on May 26. 

“During the pandemic, Terri’s discipline and diligence in exercising put herself in a great position for surgery and recovery,” says Gigi Weiss, Director of Rehabilitation Services at RVNAhealth, Terri’s in-home clinical team post-surgery. “She went in strong, and she came out strong.  And her intense motivation has made her a very gratifying patient. Terri’s recovery is going very well.”

Terri agrees. “I feel pretty darn good!!,” she reported a week after surgery and a week after returning home.  Terri went home the same day she had surgery, not uncommon for candidates like her, who meet certain health criteria, and pass a ‘home safety evaluation’ that confirms there are no serious mobility risks within their homes.

Terri’s assessment was seconded by her RVNAhealth team of nurses and therapists — all Danbury residents themselves — who cared for Terri at home, from the day she had surgery, throughout her speedy recovery. 

Gene Valmonte, RN Case Manager with RVNAhealth was the first one on the scene. “Terri looked remarkably well for someone who had just come out of surgery. And she just keeps getting stronger and more comfortable.”

“When I conducted Terri’s home safety eval and saw how eager and inspired she was to move forward and get her life back, I was very happy for her. I knew she would work hard, follow precautions and never look back,” says Joe Naber, OT, “She has navigated her home – including several flights of fairly steep steps – very gracefully.”

Jose Garduque, PT, Terri’s physical therapist, sums it up. “My job with Terri,” he says, “has been to strike the right balance of encouraging her to follow her incredible strength and will without incurring any risk to recovery. Sometimes too much too soon can backfire, but that hasn’t been the case with Terri. She has been incredible.”

“I am so happy I was able to have my surgery,” agrees Terri. “Everyone has been so wonderful from start to finish. Now, I just need the gym to re-open.”  Soon enough!

June 11, 2020

Outside inline skating accident for boyOrthoConnecticut’s urgent care service, OrthoCare Express, has proven to be a valuable resource during the Covid-19 global pandemic. Just about every parent in Fairfield County has uttered the words to their child, “Don’t get hurt! I’m not taking you to the emergency room!” People have avoided hospitals, especially the emergency rooms, for fear of contracting the virus or adding more caseloads to already overloaded facilities.

One local mom, thrilled with OrthoCare Express’ emergency walk-in location in Danbury, exclaimed, “I kept telling my kids to be careful because I didn’t want to take them to the ER. Unfortunately, I forgot to tell that to my husband! He fell and instead of the ER, I drove him to OrthoCare Express in Danbury where he was X-rayed and cast in no time at all. We avoided the ER and taught my husband an important lesson…to always listen to mom!”

At OrthoCare Express, patients in emergency situations can receive an accurate diagnosis and treatment plan from an orthopedic surgeon or orthopedic physician assistant. The facility offers the convenience of on-site digital X-ray technology, casting and splinting services. The urgent care office is currently open Monday-Friday, 8 am-5 pm and Saturday and Sunday 9 am-3 pm at 2 Riverview Drive in the Berkshire Corporate Park in Danbury. Visit www.orthocareexpress.com for specific urgent care information, or www.myorthoct.com for information about OrthoConnecticut’s Board-certified surgeons, areas of expertise and office locations.