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Active Keeping you...

Summer 2013

Sports Medicine • Orthopedic Excellence


Shoulder surgery allowed athlete to return to strenuous CrossFit training

Keeping you... … is a quarterly newsletter from West Tennessee Bone & Joint Clinic. The clinic’s 11 physicians specialize in sports medicine, hand injuries and disorders, and orthopedic diseases and musculoskeletal injuries. For copies of this newsletter, contact Adam Kelley, Marketing Director, at 731.661.9825.

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Physician pioneers wide-awake hand surgery n Preventing heat-related illness n New look, new features n Patient with osteoarthritis praises her physian

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ennie Keel is passionate about CrossFit – the strenuous strength and condi tioning program that mixes weightlifting, gymnastics and cardio exercises. It’s not only her favorite sport; it’s also her dream job. But four years ago, she tore her labrum in both shoulders Jennie Keel while demonstrating an Olympic weightlifting maneuver called a split jerk. She knew right away she was hurt. Keel saw Dr. Adam Smith at West Tennessee Bone & Joint Clinic. He confirmed the injuries with an MRI and helped her decide what to do next. “He told me to tolerate it as long as you want and come back and see me when you can’t tolerate it anymore,” Keel said. With the help of physical therapy a couple times a year at West Tennessee Bone & Joint, Keel worked through the pain as it grew increasingly worse over time. By November 2012, it was unbearable. “I couldn’t drive my car,” Keel said. “I couldn’t hold my steering wheel.” She could no longer participate in CrossFit, and she couldn’t share her love for the sport with her clients. She owns CrossFit Jackson with her husband, Jayson, and their business has grown from a group of friends exercising in a park to a new building on Executive Drive. They have 165 clients from kids to adults who rely on them as fitness instructors. “I was personally devastated,” she said. “My sport, my passion and my profession where affected, so it was time to get it fixed.” Dr. Smith performed surgery on her left shoulder in November and on her right shoulder in February. He told her to expect recovery to take at least six months.


Today, she said her shoulders are back to 90 percent, and she expects to fully recover – particularly because she closely follows the advice of Dr. Smith and the clinic’s physical therapists. “I did everything they told me to do,” Keel said. She’s CrossFit training again, and she’s coaching her clients. She said she’s very appreciative of Dr. Smith and the West Tennessee Bone & Joint staff for helping her return to her favorite sport. “They’re great; I love them. They care about what you care about. They take into consideration what your goals are, and they work with you.”

Jennie Keel uses her CrossFit training in a competition.

731.661.9825 n 888.661.9825 n

Wide-Awake Surgery

Hand surgeon pioneers carpal tunnel surgery with numbing medicine rather than general anesthesia r. Michael Dolan at West Tennessee Bone & Joint Clinic is General anesthesia is also a vascular stressor, Dr. Dolan said, and papioneering a new kind of hand surgery that many in the tients often feel as if they have just run a race. With wide-awake surgery, medical community thought was impossible five years ago. the numbness of the lidocaine wears off after about six hours. Instead of general anesthesia, Dr. Dolan injects a mixture of lidoPatients are injected with Marcaine after the procedure, which caine and epinephrine into the wrist of patients to numb the area for prevents them from experiencing pain for another 24 hours. By that surgery. Although dentists commonly use the injection, medical stutime, the pain is gentle enough that it can be treated with ibuprofen. dents were taught for decades not to inject epinephrine – or adrenaSome patients have had the wide-awake procedure on their lunch line – into the hand, Dr. break and returned to work Dolan said. for the rest of the day, Dr. “It’s something totally Dolan said. And, because the new,” said Dr. Dolan, who is recovery period is less board certified in both genpainful, patients often don’t eral surgery and hand surgery. need the regimen of Epinephrine constricts painkillers that can become blood vessels, which allows addictive and that are associthe localized numbing effects ated with the aftermath of of lidocaine to last longer, but traditional surgery, he added. the medical community “Many people go through feared for a long time that it the wide-awake surgery withwould restrict blood flow to out a single narcotic.” the extent of killing the hand. General anesthesia also That has been proven wrong, carries the risk of complicaThis year, about 75 percent of Dr. Michael Dolan’s carpal tunnel patients were wide tions that could be fatal. As a Dr. Dolan said, and wideawake as he performed surgery on their hand. awake hand surgery is a reresult, wide-awake surgery is markably easier experience safer. It’s also cheaper for pafor patients. tients and faster for doctors to perform, he said. Patients do not have to abstain from eating “It allows us to get patients in and out of the operating theater or drinking. They keep their street clothes on much quicker.” and receive a single shot in the wrist, which is Dr. Dolan has performed wide-awake surgery on patients from less painful than the IV required for general ages 12 to 95, though, typically on patients with carpal tunnel synanesthesia. They then sit painlessly through drome or trigger finger. He also uses the procedure to remove a bethe procedure while Dr. Dolan nign cyst or to repair a hand after a laceration or carries on a conversation with other trauma. Some patients have them, he said. In 2010, the first year he performed the tech“Then they stand up, walk had the wide-awake nique, 10 percent of his carpal tunnel surgeries were out and go home.” wide-awake. The number grew to 30 percent in procedure on their It is not uncommon for pa2011 and 50 percent in 2012. This year, 75 percent Michael Dolan, M.D. of his carpal tunnel surgeries have been done with tients to spend a night – or lunch break and the patient wide awake. more – recovering in the hospital after general anesreturned to work for “We’ve all just been wowed about it because the thesia. The required prep work also can require them patients just do so well,” Dr. Dolan said. to arrive at the surgery center hours in advance.


the rest of the day.

West Tennessee Bone & Joint Clinic holds drawings to award gift baskets to those who have filled out our online patient satisfaction survey. Read what one patient has to say, back page. To fill out the survey, visit


Let’s get a physical! bout 600 to 700 high school student athletes walked through the doors of West Tennessee Bone & Joint Clinic in May to get a physical. TSSAA requires an annual physical before an athlete can play a sport. Bone & Joint physicians did physicals for students at North Side, South Side, Madison and South Gibson County high schools, University School of Jackson, Jackson Christian School and Trinity Christian Academy.

Preventing heat-related illness ummer’s heat and humidity are officially here. According to the national Centers for Disease Control, more than 300 Americans die every year from heat-related illnesses. When exposed to excessive heat, the body can be unable to properly cool itself, leading to dangerously high body temperatures and medical conditions, such as heat exhaustion and heat stroke. Let’s take a quick look at some helpful facts to help you avoid a heat-related illness …


Website offers new look, videos, easy navigation esides a complete redesign, the biggest change to our website is the addition of an interactive section on orthopedic injuries. We explain how the joint works and what will happen in surgery through pictures and video. You also can request prescription refills, ask insurance and billing questions, fill out patient forms online and tell us what you think with our online patient-satisfaction survey. You’ll find past newsletters and stories, too. You’ll appreciate the patient-friendly navigation on our site. Visit us at


n Elderly people (65 and older), infants and children and people with

chronic medical conditions are the most vulnerable to heat stress.

n Air conditioning is the best protection from heat. During peak sun

hours, try to stay indoors. If your home is not air conditioned, visit public facilities such as shopping malls, libraries or movie theaters to stay cool. n If you must be outside, drink plenty of water to stay hydrated, seek out shady areas, and take frequent rest breaks from your activity. n Avoid coffee, alcohol and tea, which contribute to dehydration. n Wear a hat and loose, light-colored clothing to dissipate heat. n Recognize the signs of heat stroke: high body temperature, rapid pulse, difficulty breathing, the absence of sweating with hot red and flushed skin, hallucinations, confusion and disorientation. Written by Jesse Gatlin, Physical Therapist

Despite severe osteoarthritis, patient stays active with help from West Tennessee Bone & Joint Clinic icki Johnson, associate vice president for academics at Freed-Hardeman University, is very familiar with West Tennessee Bone & Joint Clinic and its staff. She’s battling osteoarthritis in just about every joint from everyday wear and tear, she said. She also has had a series of major surgeries. And through them all, Dr. Kelly Pucek has been there to help her navigate her options and make the best decisions about her joints. “I have a tremendous amount of confidence in him,” Johnson said. “He’s a very caring doctor. He will listen to you and answer your questions.” In 2005, Johnson had both knees replaced, which greatly reduced her pain after she recovered from the procedure. “The knee replacement is the best thing I’ve done,” Johnson said.


In 2009, she had surgery to repair a tendon in her foot. And in 2012, she went in for shoulder surgery. Johnson said an MRI of her shoulder showed bone spurs, but during the procedure to remove them, Dr. Pucek discovDr. Kelly Pucek and patient Vicki Johnson ered and repaired a shredded more, Johnson said Dr. Pucek doesn’t rush tendon in her bicep and a partial rotatorinto doing surgery. Instead, he looks for cuff tear. “The pain is much more bearable other ways to manage her pain until it’s than it was before the surgery.” too much to bear and surgery becomes the She said that, in addition to annual visits for knee X-rays, Dr. Pucek is keeping best option. “He is an excellent doctor, and the an eye on her shoulder to monitor its nurses are very kind,” Johnson said. She progress. She may need another proceadded that her experience has been great dure. She also may need hip surgery, she at West Tennessee Bone & Joint, and she said. has referred two or three of her friends to Although she’s been through multiple the clinic as a result. surgeries, and she may have to endure

Lowell Stonecipher, M.D.

Michael Cobb, M.D.

David Johnson, M.D.

Kelly Pucek, M.D.

Harold Antwine III, M.D.

David Pearce, M.D.

Jason Hutchison, M.D.

Adam Smith, M.D.

J. Douglas Haltom, M.D.

Michael Dolan, M.D.

John Everett, M.D.

Donna Klutts, CMPE Practice Administrator

Keeping You Active The physicians at West Tennessee Bone & Joint Clinic, P.C. specialize in comprehensive orthopedic care for adults and children. This includes sports medicine, hand injuries and disorders, orthopedic diseases and musculoskeletal injuries. Our physicians are Board Certified.

They see patients in …

Jackson • Brownsville • Selmer Lexington • Parsons • Dyersburg Union City • Bolivar • Ripley

24 Physicians Drive, Jackson






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