Shoulder bursitis is a common inflammatory condition of a fluid filled sac in the shoulder that functions as a cushion between the rotator cuff tendons and bone. Symptoms usually occur in patients over forty who are involved with repetitive overhead activities often related to sporting activities or work. Shoulder bursitis can occur from a specific injury but frequently is noted without any significant trauma. Patients usually complain of a sharp deep pain within the shoulder often radiating down the outer side of the upper arm when raising the arm overhead. Pain during sleep is also common.

Standard treatment consists of anti-inflammatory medication and physical therapy for strengthening of the rotator cuff and shoulder girdle musculature. Often an injection of cortico-steroid medication directly into the bursa is required to reduce or cure the patient's symptoms. Failure of non-operative treatment can be associated with a bony spur located above the bursa. Removal of the spur and inflamed bursa can be accomplished with a short outpatient arthroscopic surgical procedure. Following a brief period of rest and rehabilitation, patients are expected and encouraged to return to normal activities.

Peter S. Borden, MD
Diplomate, of American Board of Orthopaedic Surgery
Shoulder and Knee Sports Medicine Specialist
Member, South Bay Independent Physicians Medical Group, Inc.

Yes, and no. Cranberry juice contains an elusive ingredient which has been shown to reduce the incidence of bladder infections. However, cranberry juice is also very acidic, which is not good for the urinary tract. Some people have a sensitive bladder lining, and they develop pain and burning with urination when they consume acidic fruits and beverages.

The same symptoms can also occur after eating spicy foods and drinking beverages containing alcohol, caffeine, and carbonated (fizzy) beverages. Many times these individuals think they have a bladder infection, while in fact they do not. Many patients have told me, "I keep drinking cranberry juice, but it just keeps burning". When they stop drinking the cranberry juice the pain magically resolves.

Cranberry juice, cola, coffee and tea also contain oxalate, which contributes to kidney stone formation. Ask anyone who has had a kidney stone how painful it is and you will surely want to avoid getting one. If you have already had a kidney stone it is especially important to reduce the oxalate in your diet. Other sources of oxalate include spinach, beets, nuts, chocolate and many fruits. Those wishing to avoid a kidney stone are also advised to avoid excessive sodium intake, but in all but rare cases calcium restriction is not necessary.

Jill G.Byers, M.D,
Diplomate, American Board of Urology
Member, South Bay Independent Physicians Medical Group, Inc.

All facial lines are created by muscle contractions and increased by sun damage and smoking. If a facial wrinkle is primarily present when animating the face, Botox ™ can be used to prevent the muscle contracting for 3 to 4 months. Crow's feet, frown lines and forehead wrinkles, are well treated with Botox, but not areas around the mouth and lips.

If a wrinkle or line is already present, injectable filler is a better solution. Collagen injections are easy to accomplish but only last 3 to 4 months. Radiance™ (calcium hydroxylapatite) lasts 3-5 years and is growing in popularity because of its long lasting characteristics. Both can be used to enlarge lips, minimize lines around the mouth and lips, fill wrinkles and grooves in the cheeks, forehead and other facial areas.

Harold J. Kaplan, M.D., FACS
Diplomate, American Board of Facial Plastic Surgeons
Member, South Bay Independent Physicians Medical Group, Inc.

In a healthy woman, there is no limit to the number of years she can remain on birth control pills. There is no need to "give your body a break" from the pill, unless you are ready to get pregnant. Use of birth control pills does not alter the chance of getting pregnant in the future. Use of birth control pills is safe in healthy, non-smoking women older than 35 years and can be used until a woman goes into menopause (which is usually between the ages of 50 and 55).

Taking birth control pills offers many benefits in addition to providing effective contraception. Perimenopausal women benefit from more regular periods, reduced hot flushes and strengthening of bones. Women on oral contraceptives have a decreased chance of ovarian and uterine cancer. They often have lighter periods of shorter duration, less cramps and less irregular bleeding. There is a decreased chance of benign breast disease, as well as a decreased incidence of pelvic inflammatory disease. In the right woman, the birth control pill is an excellent long or short-term choice for contraception.

Latrice Allen, M.D.
Diplomate, American Board of Obstetrics and Gynecology
Member, South Bay Independent Physicians Medical Group, Inc.

Influenza or the "flu" is an acute respiratory infection caused by the Influenza virus. Symptoms include headache, body aches, fatigue, fever, chills, and dry cough. Rarely are there symptoms of sore throat and nasal congestion. The duration of the illness ranges from 1 to 2 weeks. Treatment is primarily symptomatic and includes getting plenty of rest, drinking fluids and taking over the counter pain relievers/fever reducers and cough suppressants. Medications that may shorten the duration and severity of the illness are available by prescription.

A serious and sometimes fatal complication of the flu is pneumonia. Make sure to report to your doctor if symptoms worsen or fail to improve. Fortunately, there is a vaccine against influenza. Currently there are two forms of the vaccine. One form is injected. A newer form is sprayed into the nose. It is best to get vaccinated early in the Fall, before the flu season begins. Ask your doctor if you are a candidate for the flu vaccine.

Elizabeth D. Duenas, M.D.
Diplomate, American Board of Family Practice
Member, South Bay Independent Physicians Medical Group, Inc.