Arthroscopy has become one of the greatest advancements in the last twenty years in diagnosing and treating various joint injuries and disorders. The shoulder, knee, and ankle are the most common areas of the body where arthroscopy is performed.

Arthroscopy is derived from the Greek words "arthro" = "joint" and "scope" = "look". The arthroscope is a fiber optic instrument about the size of a pencil that is inserted into the joint through a small 5mm incision. At the tip of the arthroscope is a camera that enables a surgeon to view the entire joint on a video monitor. The images are magnified to allow for thorough examination of ligaments, tendons, and cartilage.

Abnormalities can be treated with special instruments inserted into the joint through other small incisions. Arthroscopy can provide patients a timely recovery and enhances cosmesis while avoiding many disadvantages associated with more invasive surgical procedures.

Peter S. Borden, M.D.
Orthopedic Surgeon and Sports Medicine Specialist
Member, South Bay Independent Physicians Medical Group, Inc.

Up to 52% of latex-allergic patients are also allergic to certain foods, the most common cross-reactivity is to fruits particularly avocados, kiwi, or bananas. This food sensitivity also extends to other foods such as potatoes.

When latex-allergic patients react to a food that doesn't usually cause a problem, inadvertent contamination from a food handler's latex gloves should be suspected. Latex contains about 240 proteins, 57 of which are known allergens. Skin tests have proven reasonably accurate in detecting latex allergy. There are also blood tests that are excellent at diagnosing latex allergy. A recent trial of allergy vaccine therapy was successful in preventing some of the symptoms of latex allergy, but further work needs to be done before this is available.

Allan D. Singer, M.D.
Diplomate, American Board of Allergy & Immunology
Member, South Bay Independent Physicians Medical Group, Inc.

I was just diagnosed with fibromyalgia, and I've never heard of it. Can you tell me what this is?

Fibromyalgis is a syndrome, meaning that it is a collection of symptoms that occur together. Not all patients have all of them, and women are affected more than men; only about 20% are male. It also occurs in children, and most researchers now believe it is an inherited condition. The name fibromyalgia means, "pain in muscles and fibers" and this pain must have been present in all four quadrants of the body for three months duration.

Diagnosis is made by the presence of tender swollen areas that hurt when a small amount of pressure is applied to them. However, since pain thresholds vary, not all patients have significant pain, for some the primary complaint is fatigue. Other symptoms include: headaches, irritable bowel syndrome, irritable bladder, vulvodynia, problems with memory and concentration, anxiety, nervousness and depression, and sensitivity to sound, light and odors.

Fibromyalgia is not new or rare; it was previously called "fibrositis" or "rheumatism" and had been well described in medical literature by the 1840's. Conservative estimates place the number of Americans with this disease at about six million people, four times as many as will be diagnosed with cancer this year, and six times as many people who are living with HIV.

R. Paul St. Amand, M.D.
Specialist in Fibromyalgia and Endocrinology
Member, South Bay Independent Physicians Medical Group, Inc.

Yes, Insurance companies do pay for medically necessary breast reductions. However, one must meet the criteria of that particular insurance plan before a decision can be made.

Presuming your insurance company does not have an exclusion for breast reduction, one simply must go through the, "pre-authorization process". Here, appropriate steps are taken to ensure a smooth process from written authorization to payment. The surgeon examines the patient, and then determines if in fact this is a medically indicated condition.

Physical symptoms such as neck pain, severe back pain and shoulder-strap indentations are reviewed. If indicated, your surgeon includes these finding in his/her request for medical authorization. Previous chiropractic treatment and other unsuccessful conservative therapy are often valuable. Surgical recommendations are outlined and once reviewed and approved by a medical committee, a document of medical authorization is received by both the patient and the surgeon, which allows for the surgery to proceed, and most importantly, ensures that your breast reduction will be paid for by your insurance carrier.

Grant Stevens, M.D., F.A.C.S.
Diplomate, American Board of Plastic Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Why is it important for diabetic patients to see an ophthalmologist?

Approximately 14 million Americans have diabetes mellitus. Diabetes, especially when poorly treated can cause numerous systemic complications, such as kidney failure, hypertension, and cardiovascular disease. Diabetes is also one of the leading causes of blindness among working-age Americans. Many patients with diabetic eye problems are asymptomatic, despite the presence of vision-threatening disease. If diabetic eye disease is left untreated, it can lead to serious visual loss. Decreased vision due to diabetes can be caused by several mechanisms, and treatment for the decreased vision needs to be tailored to the individual's needs.
Blood sugar elevation in diabetes causes the destruction of small blood vessels (capillaries) throughout the retina resulting in a lack of blood supply to small patches of the retina. The damaged blood vessels also tend to leak, producing swelling within the retina. This disease of the retinal blood vessels is known as diabetic retinopathy. Approximately 25% of diabetics have some degree of diabetic retinopathy. Left untreated, diabetic retinopathy can lead to severe loss of vision. With the use of modern ophthalmic lasers, much of the vision loss can be prevented if caught in the early stages of the disease.
Aarchan Joshi, M.D.