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Marathoner shatters knee; he’s back to running after surgery

Keeping you...

… is a quarterly newsletter from West Tennessee Bone & Joint Clinic. The clinic’s 12 physicians specialize in sports medicine, hand injuries and disorders, orthopedic diseases and musculoskeletal injuries, and interventional pain management. For copies of this newsletter, contact Adam Kelley, Marketing Director, 731.661.9825.


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r. John Carraher was 15 miles into a 50 kilometer race on Mount Cheaha — a remote area in Alabama’s Talladega National Forest — when he slipped and shattered his kneecap. Despite completing almost 50 marathons, including some ultra marathons and the 115 mile “TransRockies Run,” Dr. Carraher couldn’t walk, and he was too deep into the woods to be carried out. A rescue helicopter plucked him out of a clearing in a basket and dropped him off by the side of a nearby road where an ambulance took him to a hospital in Anniston, Ala. About five hours had passed from the time he injured his knee to the time he arrived at the hospital.


Read more … Physician helps patients with chronic pain regain active lifestyles n Why is my back hurting? n Down! Set! Hut! n Ultrasound useful for orthopedic patients

Winter 2014

Dr. Carraher shattered his kneecap during a 50k run and had to be airlifted out of the woods, far right.

Dr. Carraher, who is a board-certified urologist at Jackson Urological Associates, chose to return to Jackson for treatment. He went straight from the Alabama hospital to the house of West Tennessee Bone & Joint’s Dr. David Johnson, who saw him briefly and scheduled surgery the next day. “He screwed and wired my kneecap back together,” Dr. Carraher said. “It was pretty smooth — there were no problems.” And then Dr. Carraher began physical therapy: three days a week for four months, then two days a week for another two months. It was painful and required a lot of hard work, but it was a good experience, he said. “ey just did a great job of answering questions and telling me what was going to happen.” Despite his medical training, Dr. Carraher said his injury was not a common one and therefore difficult to gauge his progress and compare himself to other athletes. “What happened to me is a freak accident that not many people have.” He worked hard in physical therapy Continued on Page 2 …

731.661.9825 n 888.661.9825 n

Physician helps patients with chronic pain regain their active lifestyles r. Eric Jon Homberg, who has joined West Tennessee Bone & Joint Clinic, is a board-certified anesthesiologist who specializes in interventional pain management and helping patients regain an active lifestyle. Dr. Homberg uses a multimodal and balanced approach to treating patients with the prescription of therapies, medications and minimally invasive procedures to help with recovery and pain management. He has pursued additional training in new and innovative procedures to provide patients with more choices. “Interventional pain management is a relatively new field of medicine,” Dr. Homberg said. “It was developed to help patients suffering from chronic pain who are not candidates for, or who do not wish to undertake, surgical correction.” He primarily treats patients with injection procedures aided by fluoroscopy — intermittent X-rays and ultrasound — to deliver medications to the source of the pain without impacting the rest of the body. He said the method is not a replacement for surgery, but it is a middle ground for patients in search of options. When treating patients, Dr. Homberg said he asks them about their goals for recovery before embarking on a clearly defined path of pain management. Many of his pa-


Dr. Carraher to get better, and he has come a long way. Today, Dr. Carraher said he can walk and run without much pain. However, he said, he still has a long way to go to fully recover. “You really have to stay focused and have goals to

pain under control, he said. Prescription drug abuse is a national epidemic, and Dr. Homberg said a successful approach to pain management is a balanced regimen of physical therapy, procedures to manage pain, medications and surgery when appropriate. “We try to minimize the usage of opioid pain medications. We really strive to treat the patient without giving them another problem.” Dr. Homberg has lived in Jackson for 13 years. He earned his medical degree from the University of Tennessee Center for the Health Sciences in Memphis, which is also where he completed Dr. Homberg performs a nerve block procedure. his residency. He is a member tients battling chronic of the American Medical Association, Ameripain are elderly. can Society of Anesthesiology, American Soci“Very often, they ety of Interventional Pain Physicians and want to be able to American Academy of Pain Management. work in their rose garDedicated to keeping people active, Dr. den or pick up their Homberg is an advocate for patients who are grandchild,” he said. desperate for understanding, encouragement “I like to make all our and treatment to overcome the physical and treatment efforts tomental challenges of chronic pain. wards a specific goal “Before entering the specialty of pain Eric Homberg, M.D. of the patient.” medicine, I didn’t appreciate the number of Because a variety of pain management people who suffer with debilitating, chronic techniques are associated with intervenpain — especially the elderly population,” he tional pain management, patients don’t have said. “I’ve just been shocked with the prevato rely as heavily on narcotics to bring their lence of it.”

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get through any type of injury.” e accident occurred in February 2013. He began running again in July. In November, he ran the Fall Back Half Marathon in Jackson. In April, he ran the 2014 Boston Marathon, finishing in four hours, nine minutes.

Dr. Carraher, left, recovers after shattering his kneecap. He ran the Boston Marathon in April.

Why Is My Back Hurting? he unfortunate truth is most people will suffer from low back pain at some point in their lives. Back pain is one of the most common reasons that cause people to go to a doctor or miss time at work. ere are many possible causes of back pain, and choosing the correct course of treatment depends greatly on the source of the problem. Here are some of the potential reasons why your back may be hurting: n Muscle strain: e back contains several muscles that are susceptible to injury if overloaded from over-activity. is can be a result of recreational sports, working out, lifting something heavy, or a hard day of yard work. Strains typically respond well to rest, stretching, and anti-inflammatory medications and can resolve in a few days’ time. n Disk injury: Located between each of your vertebrae is a small donut-shaped disk which serves as a cushion for the spine. Sometimes the soft, jelly-like material in the center of the disk can push through


By Jesse Gatlin, Physical Therapist the outer rings and press into a spinal nerve, causing pain in the low back and possibly pain, numbness and weakness in one or both legs. In more serious cases, the disk can rupture completely. Bending, lifting and twisting movements and prolonged sitting typically aggravate pain from a disk injury. n Degeneration: As a normal part of the aging process, lumber disks and the cartilage lining the spinal joints

can begin to wear down, or degenerate. is causes a narrowing of the spaces around the spinal cord and the spinal nerves as they exit the spine. is condition causes pain and stiffness in the low back and makes it difficult to tolerate standing or walking for long periods of time. Both disk injuries and degeneration can benefit from a specialized exercise program to stretch and strengthen the spine. ese are only a few of the many sources of low back pain. Consultation with a physician or physical therapist can help you pinpoint the proper course of treatment for your specific ailment. Of course, the most effective treatment method of all is prevention through a healthy lifestyle. To reduce the risk of developing back problems, you can exercise regularly, practice good posture and lifting techniques, and maintain a healthy body weight. Even if back pain or injury is unavoidable, these measures will lessen the impact that it can have on your life.

Down! Set! Hut! A football banquet!


est Tennessee Bone & Joint Clinic was the proud sponsor of the Seventh Annual Southwest Football Officials Association Banquet in December. e banquet included football officials and coaches, athletic directors and their families. Former TSSAA Executive Director Ronnie Carter was the keynote speaker. At far left, West Tennessee Bone & Joint Chief Executive Officer Donna Klutts stands with Billy Schrivner, a TSSAA official for more than 40 years and a member of the TSSAA Hall of Fame. Near left, the clinic’s banner hangs above the podium while Larry Lewis addresses the audience.

Ultrasound useful for orthopedic patients ltrasound imaging has been used in many surgical subspecialties to assist with diagnosis and management of medical conditions. Its use in orthopedic conditions has been gradually expanding. Your West Tennessee Bone & Joint Clinic provider may use this technology to diagnose injuries to tendons or muscle, or to assist with minor procedures such as injections. Let’s review the basics of diagnostic ultrasound and its potential uses in orthopedic patients …


How does ultrasound work? n

A handheld transducer is used by the surgeon on the affected part. e transducer emits high frequency sound waves. n ese sound waves travel into the body tissues. Millions of pulses and echoes are sent and received each second. n Tissues have differing densities and reflect or absorb these sound waves differently.

Lowell Stonecipher, M.D.

Michael Cobb, M.D.

Adam Smith, M.D.


Ultrasound is relatively inexpensive compared to MRI or CT. n Ultrasound is dynamic. is means that joints, muscles and tendons can move during the exam, allowing your surgeon to assess the injury in different positions. n Ultrasound is frequently used to guide injections. While many injections have been done based on superficial and palpatory anatomy, dynamic ultrasound guidance may be indicated to allow for increased injection accuracy.

By Adam Smith, M.D. For example, bone completely reflects the sound waves, and normal knee fluid allows the sound waves to pass through unreflected. n e reflected waves are picked up by the probe and relayed to the computer, which calculates distance from the probe to the tissue based on the time of each echo's return (millionths of a second). n e machine displays the distances and intensities of the echoes on the screen, forming a two-dimensional image. n e probe can be moved along the surface of the body and angled to allow for the best possible view of the damaged structure.

Dynamic ultrasound imaging can be used to assist with diagnosis and management of musculoskeletal injuries. It allows for “real-time” assessment of injuries and is cost-effective. While ultrasound is extremely useful, many injuries still require other options, such as MRI to maximize imaging accuracy. Feel free to discuss these options with your surgeon.

Why is ultrasound useful? n

Ultrasound is non-invasive and not painful. n Ultrasound has no harmful radiation.

David Johnson, M.D.

J. Douglas Haltom, M.D.

Kelly Pucek, M.D.

David Pearce, M.D.

Harold Antwine III, M.D.

Eric Homberg, M.D.

John Everett, M.D.

Keeping You Active Michael Dolan, M.D.

Jason Hutchison, M.D.

Donna Klutts, CMPE Chief Executive Officer

The physicians at West Tennessee Bone & Joint Clinic, P.C. specialize in comprehensive orthopedic care for adults and children and interventional pain management. This includes sports medicine,

They see patients in …

hand injuries and disorders, orthopedic diseases and musculoskeletal injuries.

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

24 Physicians Drive, Jackson






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