Episode 68 - Dr. Raj: Save Your Back, Hips, Knees. Joints Now

Transcript

Teri Struck: I’m Teri Struck, host of Beauty Now, a weekly podcast that brings you beauty from the inside out. Since I’ve been a child I’ve been fascinated and teased by my own father, who said I would put mud from the garden on my face if I thought it would help. Of course he’s half right. Now I’m really interested on beauty from the inside out, but I’m also wanting to look good and feel good. It’s all about being healthy. We live in a society where we’re so lucky to have such major technology and great experts at our disposal. Today we’re really lucky, we have Dr. Raj, who’s a board certified orthopedic surgeon, and he’s all about being healthy. And he’s going to be here today to tell us about keeping our back healthy, keeping our lifestyle healthy. Welcome Dr. Raj.

Dr. Raj: Thank you. My aspect within a show like this is feeling good with inside so you feel good on the outside, as an orthopedic surgeon. And, you know, essentially the biggest problem with our population, it’s a silent disease and it’s obesity and it’s leading to all sorts of orthopedic issues such as, like you said, back pain, people getting addicted to medications, knee pain, any pain that is in a joint that takes on weight, such as your knees, your hips and your back.

Teri Struck: Well the problem that I think with like a lot of people is that when you do gain weight it’s so hard to get motivated to lose it. So how do you motivate your patients?

Dr. Raj: Well first of all what’s happened is, you know, over the years, when I was a child 20 years ago, you know, we used to go outside and play sports. I think our population was a lot more active. And then technology came on the board and the internet was introduced to us, videogames, and threw out all these changes. Nowadays what I see with kids is I see kids sitting inside playing video games or on the internet for hours upon hours, versus outside being more active and being more creative playing sports. So this starts off, it starts off as a child. And it offsets into your young adulthood and older adulthood. If you’re activity level is basically seven Teri, you know, your diet is going to be not so good as well. It’s all correlative. So if you’re playing videogames and probably sitting down eating junk food, your metabolism’s not up and you start gaining weight. As a child you don’t think about it, but you start incurring problems because for every pound you gain, for example in your knee, going up and down stairs, you add on seven pounds of joint reactive force infection. So you think about that point loading on your poor cartilage over time, you know, your cartilage is going to degenerate, your muscles aren’t conditioned so you’re more apt to injure yourself versus protecting your joints, and then you start relying on medication, so you start having, someone who’s obese having back pain, hip pain or knee pain, start taking Vicodin or anti inflammatories to be able to control pain.

Teri Struck: Could you actually tell our listeners how bad is it to take Vicodin with alcohol? It is actually, kills your liver. I have a very dear friend who’s son had wisdom teeth out and mixed Vicodin with alcohol. And it’s so dangers. I don’t think that people really know and they’re not really informed, even regardless if the patient’s young. It doesn’t matter how old you are. You should never drink with your painkillers.

Dr. Raj: Absolutely. I mean Vicodin with alcohol, I mean you’re just really overloading your liver. On top of that, you start becoming addicted, I mean, to these narcotics and medications, and you develop not just the liver side effects, but I mean your personality starts changing. Someone who is on Vicodin and alcohol is definitely not a person who’s on the right track to getting back their life.

Teri Struck: It destroys relationships. I have a very good girlfriend who just went through rehab for it, and I think it’s one of the harder addictions to break, isn’t that true?

Dr. Raj: It’s absolutely one of the toughest addictions to break. And it’s all stemming from this new silent disease that’s coming through, and it’s a silent disease because most of our population has secondary effects from obesity. And as a surgeon I see a lot of unnecessary surgeries, and unnecessary in a sense that if this person would’ve controlled their lifestyle, you know, and took care of themselves, they wouldn’t need the surgery; you know, not necessary in a sense, they definitely need it, but it’s because of the secondary effects of their lifestyle and the result in obesity.

Teri Struck: Well lets just say that there are people out there that are getting heavier. What do they do to help themselves?

Dr. Raj: Well you have to give to start getting back your life, and, you know, that’s a catchphrase. And number one, you know, first of all you have to see “Why am I on this medication? What am I controlling? What is it doing for me?” Well it’s just masking the pain. It’s changing my, you know, also changing my personality – I’m more depressed, relationships – so you have to first of all recognize that this medication or narcotic is not good for you, number one. Number two, and then you have to look at what you have. If it’s back pain or hip pain or knee pain you have to, you know, go to a specialist, go to someone who can actually take care of this problem. And what I mean someone who can take care of it, not someone who will mask the problem by giving medications, but someone who will actually give you diagnosis, work you up and create a plan in order to correct the situation.

Teri Struck: One thing I hear from specialists and doctors too is the first thing you have to do is you have to want change too. And I think what you’re saying is you’re seeing so many injuries due to obesity, and the first step is trying to help these people see how they can help themselves and get that kind of motivation. Lets just, I want to ask you one things is you’re talking about knee pain and I’m seeing this with a lot of people, the baby boomers and stuff like that, that are heavier and they’re… I have one friend who’s complaining of the planters of (unintelligible), and it’s mostly because she needs to lose weight.

Dr. Raj: Exactly.

Teri Struck: Do you just tell your patients that or…?

Dr. Raj: Well you know what, after they come see me the problem is it’s definitely a catch-22 because once you start gaining weight and you’re beyond the aspect now, you damage your knee and you damage your foot and there’s cartilage damage, you know, it’s harder now at this point to tell someone, “Okay, start exercising”, when their knee is in the condition or they have….

Teri Struck: Right, exactly. How does that work?

Dr. Raj: Yeah, so, or to tell someone, “Yeah, start swimming”, for example. I’m definitely not a swimmer, so, you know, telling someone to take up a new sport in order to lose weight when they’re in their mid 40’s, their mid 50’s is ridiculous. So when they’ve come seen me at that point, you know, right now the simple solutions are kind of bypassed and we have to kind of correct the problem and then get their lifestyle changed.

Teri Struck: Well and also I think if you’re not able to exercise by the time they see you they can just start to try to get on the healthy eating plan. And Dr. Oz was on the other day – and I do like Dr. Oz – and he said maybe it’s just best to write down and keep to your routine, to just stick with the same thing so that you can get it done. And the other advice I like is turn on music and just move in your room, do what you can, just, that’s safe. So tell us about back pain. Lets just say that you come in, you’re suffering from back pain; how do you diagnose it?

Dr. Raj: Well first of all I mean, simplistically I mean you just take history. I mean you start interviewing the patient and, you know, the patient will say, “My back pain”, they’ll localize exactly where the back pain is. The second issue is, you know, you have to quantify what type of pain is this; is this activity related pain? A lot of people say, “It’s when I’m in bed or when I’m lying flat or when I’m not doing anything, I have no pain”, and that’s not the solution.

Teri Struck: Not to sit in your bed, but then how do you know it’s not something more serious?

Dr. Raj: That’s where they need, you know, people of my nature, orthopedists, orthopedic surgeons, you know, especially if you can look into it and see what’s going on, and you’re absolutely right. I mean sometimes back pain can be as bad as tumors, which I’ve seen, secondary to multiple myeloma or cancers or metastases or… and in most cases it’s just basically mechanical back pain from overload and secondary arthritis in small joints. And then in between this we worry about sciatica and (unintelligible). So obviously on our exam we would just, you know, do a number of clinical tests, and then probably proceed to an MRI, depending on – an MRI and also plain x-rays – depending on how long this pain has been going on for. And then most of the times, I’ll be honest with you, I found out most of these back pains are mechanical in nature, secondary to obesity and overload on those small little what we call facet joints, which connect the vertebrae.

Teri Struck: And we need to take a commercial break really quick. We’re talking with Dr. Raj, and he’s going to be back with great back advice and advice for your sedentary lifestyles. Get off your chair, get up, get moving. We’re going to be right back with personallifemedia.com. This is Teri Struck with Beauty Now.

Teri Struck: I’m Teri Struck, host of Beauty Now. And we’re talking with Dr. Raj, an orthopedic surgeon whose giving us really great advice about how we can stay healthy and stay out of his operating room. Welcome back Dr. Raj.

Dr. Raj: Thank you.

Teri Struck: We want to stay off the table and not have to go for invasive surgery, and you have this ‘get back your life’ program. So why don’t you walk us through the six steps for beginners.

Dr. Raj: Yeah. They’re very simple steps, and when you listen to this you’re going to say, “Oh yeah, this is no problem.” But it’s not saying that, it’s implementing this within your life and within your daily activities. The first step is we live in a computer era and you watch all of our kids and, you know, all of these young kids are sitting at the computer. Back in my days we had the basketball, we were outside. So number one, turn off your computer for at least one hour a day, which includes your phones, your iPods, and walk around the block.

Teri Struck: Not just kids; adults too.

Dr. Raj: That’s absolutely true. Actually all of my colleagues downstairs, everyone is on these new phones and iPods. I actually refuse to get a high tech phone. I don’t want to be stuck looking at a phone and communicating with people.

Teri Struck: That’s true. I mean the only thing that I like them for is the camera.

Dr. Raj: Exactly.

Teri Struck: Which my friends don’t appreciate at all, ‘cause it works two ways.

Dr. Raj: You know, and the second step - I mean, it’s simplistic, okay – we’re in front of a computer, we’re watching TV, we have the tendency to eat junk food. And reduce junk food to once per week – chips or cheesies or, you know – and then eat an apple or eat a banana, start eating fruits.

Teri Struck: There’s a great new show we just did, Cooking For Beauty with Elizabeth TenHouten…

Dr. Raj: Oh wow!

Teri Struck: Cooking For Beauty and Eating For Beauty with David Wolf is also good, and really easy stuff, and just simple changes. That’s great. Like an apple a day keeps the doctor away, Dr. Raj away.

Dr. Raj: Yeah. You want to keep me away because…

Teri Struck: Want to keep you away, and it’s actually admirable of the surgeon to actually give advice to stay out of the operating room.

Dr. Raj: Well, you know, like I said, as an offshoot I see way too many people, and the underlying issue is obesity, and their having their knees scoped, their knees replaced because they didn’t take care of these issues years ago.

Teri Struck: I do see so many athletes though as well though, so it’s not always just obesity, don’t you think? I mean seriously you can be playing tennis and then get the knee thing or…

Dr. Raj: Oh absolutely.

Teri Struck: But it just ups your chances.

Dr. Raj: Yeah, it’s just my personal, you know, issue of that. You know, that’s going to happen. There are athletes, there are dancers; you know, they’re going to injure themselves and they’re going to require my treatments. But when it’s because of a lifestyle issue and when I see it more and more, that’s what makes me more passionate to educate people on preventative care.

Teri Struck: So what are the best tips that you can give our listeners to have a healthy lifestyle?

Dr. Raj: Well, you know, simple: take the stairs versus the elevator.

Teri Struck: Take the stairs, right.

Dr. Raj: We’re approaching many, you know, we take many elevators and there’s the, there’s always the stairs around the corner to go up and down. Measure your weight daily. I mean it’ll just give you an idea and be more obsessive. You’ll start understanding the normal fluid fluctuations within your weight, but by measuring it daily you’ll be more obsessive about lifestyle changes – what you eat and how active you are.

Teri Struck: And when you’re watching TV do push-ups and stuff like that, or just so you’re not just sitting there watching television, if you watch TV, which I do, which I do like to.

Dr. Raj: I do too.

Teri Struck: So just get out of your chair and move while you’re watching TV, at least that.

Dr. Raj: No, that makes complete sense. I mean being more active, and I think the essence of being more active. I mean join a team or a group, you know, that, you know, will play basketball, go for walks, go for hikes, you know, just to get you outside. And also the biggest thing is develop the will and confidence to realize that you’re actually in charge of your own destiny.

Teri Struck: Well you have to find what works for you too. I think every listener will be different. Like just go within and say, “What makes me happy?” A walk, tennis, basketball, whatever it is. Basketball doesn’t make me happy, but I know walking does.

Dr. Raj: Makes me happy. I’ve been injured….

Teri Struck: More men.

Dr. Raj: No, but walking’s great, walking outside. I mean there’s psychological advantages to being outside and getting fresh air versus sitting inside looking at a computer.

Teri Struck: Well that’s why I do like my iPod though. So the iPod comes in handy just to put it on and walk, ‘cause I can walk really far with it.

Dr. Raj: That’s absolutely true, but…

Teri Struck: Have your music and just move. I think iPods are different ‘cause it makes you move. And if you feel like staying in too, the new thing is the Wii Fitness Board. So many people are losing weight on that. Instead of watching TV, do the Wii Fitness Board in your room. I wouldn’t know how to turn that on though, but I do want to learn.

Dr. Raj: I’ve seen it, but I’m the same way. I’ve kind of given up on trying to learn newer technologies like that because there’s so much coming out.

Teri Struck: Well they have the tennis and they have the golf I guess for your arms, and they have Yoga. And actually it says it weighs you, but it weighs you on the screen, so I’d make everybody leave the room if you don’t want people to know your weight, so… So anyways, in closing tell us the rest, the few minutes that you have left, go ahead and talk about what else you want to talk about. Oh, back pain; we didn’t really…

Dr. Raj: Well yeah.

Teri Struck: touch on back pain.

Dr. Raj: Well the issue with back pain is you have it, you, you know… I see more and more younger people getting addicted to medications. And like I said, I mean we need to stop this trend because this person is on Vicodin or Percocets; first of all they get sensitive to these medications. Second of all they get side effects, and not just liver, they get gastric side effects, so it starts eroding their stomach and it starts changing their personality. And I see more and more people thinking that this is the solution to your problems and not realizing that it’s just a bandaid, and it’s a temporary lethal bandaid. I mean we’ve seen a lot of celebrities as well; I mean they’re addicted to medications. It all stems from initial pain.

Teri Struck: Well lets just, I mean how does somebody know their addicted. I mean I was horrified to learn of a very dear friend who was, had several back surgeries, and then she admitted that she was taking tons of Vicodin and Percocet and Ambien and all these things to bring her up and down, and her family still hasn’t done an intervention. I did try, but I think that it’s scary. I mean I think there comes a point where you can’t help somebody unless they want to be helped, but I don’t know. I’m pretty sure if you have a loved one in your family you need to do an intervention. You need to get your family and friends and go and do an intervention and get help, get a doctor to help you.

Dr. Raj: Yeah. I mean when you start realizing that you’re taking, you know, insurmountable number of Vicodins on a daily basis on a chronic need, so over months - and number one, you feel it’s not helping you; number two, you’re adding on more medications; number three, when you don’t take it you’re calling the doctor right away for a refill – those are indicators that your lifestyle’s changed and you are becoming addicted because you’re becoming obsessed with this one medication. When you start becoming obsessed about it, that’s when, that’s an initially indicator that, of addiction.

Teri Struck: And if you think you have a problem then talk to a specialist about it. I don’t know because I mean they say this is the hardest addiction to break, so I think that it’s really important that you surround yourself with friends and family and admit your problem.

Dr. Raj: Yeah, you’re definitely right. I mean it is one of the hardest addictions to break and, you know, it’s identifying that within yourself, ‘cause we’re all, we all use our minds and think that we’re in control and, yeah, we can stop this anytime. But it’s not true. I mean this is an issue where we need help. We need our families around us, we need people around us to, our friends, our families to actually – and we need to listen to them, and if we recognize a change in our personalities or obsession with medications, you know, then we need to definitely seek medical help.

Teri Struck: Well that’s really good advice. And if you have a loved one that you feel is suffering from addiction, then talk to your doctor about how you can do an intervention and get help. And if you’d like some more information on Dr. Raj for back pain, any types of pain, joint pain, he’s an orthopedic surgeon in Beverly Hills and we are going to link our website, personallifemedia.com, with his, and you’ll be able to contact him. And if you have any questions, please email me at t-e-r-I, @personallifemedia.com ([email protected]). Thanks so much for being with us today. We’re out of time. We could talk all day.

Dr. Raj: I know we could. Thank you.

Teri Struck: This is Teri Struck, personallifemedia.com, and we’re with Dr. Raj, an orthopedic surgeon in Beverly Hills. If you want to, have any back pain, joint pain, knee pain, questions for him, go to personallifemedia.com – we’re going to link you up with Dr. Raj’s website. Thanks so much Dr. Raj for being with us today. We’re going to have you back.

Dr. Raj: Thank you.