When to See Doctor Who for What

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Joints & Muscles 

Five Signs It's Time to See An Orthopedic Doctor

When it comes to our bones, muscles, joints, and soft tissues, it can be hard to tell the difference between a serious orthopedic issue and normal aging, aches, and pains. Often, orthopedic specialists can quickly diagnose what ails you and get you on the road to recovery before chronic issues set in. Dr. David Hartigan, a sports medicine physician and hip preservation surgeon at Twin Cities Orthopedics, and Dr. Dane Hansen, an orthopedic surgeon and arthritis specialist at Summit Orthopedics, share five indications that you should see an orthopedist.

1. CHRONIC, DAILY PAIN

Pay attention to chronic and consistent pain in a specific area, like your hand, shoulder, hip, or knee. It’s often paired with other symptoms, like swelling in the joint. This is typically more than just aging. It’s a signal that you’re experiencing a degenerative process like arthritis, Hansen says. “People think there’s nothing you can do and they have to live with it. But there are medications and injections and surgery to replace joints.”

2. LOSS OF FUNCTION

A red flag for Hartigan is when someone struggles to participate in the activities that make them happy for two weeks or more. It’s a concern if you have lost range of motion; you are experiencing pain from a joint, bone, or soft tissue; and your healing has stalled, Hartigan says.

3. ACUTE INJURY

When you hurt yourself from a fall, playing sports, or a random accident, it will save you time to see an orthopedist first, Hansen says. This is their wheelhouse. The largest specialty practices in the Twin Cities offer urgent care where you can get evaluated by someone who lives and breathes orthopedics. It’s especially important to see an orthopedist if you can’t put weight on a joint or move it normally.

4. FEEL THAT POP?

It’s concerning if you hear a popping sound when you injure a muscle or tendon. The sound often pairs with bruising, deformity, and swelling around the joint. It can happen in the bicep, knee, Achilles tendon, or plenty of other places. Hartigan recommends seeing an orthopedist for a fast diagnosis and treatment plan because early intervention generally is more effective.

5. BACK PAIN

Orthopedic doctors want to see you when you throw out your back. That might mean not being able to stand up straight or having so much pain that you can’t get a good breath. This is especially worrisome if you have nerve symptoms like shooting pains down your arm or leg—signs of a pinched nerve or herniated disk, Hansen says. An orthopedist can help ease pain with anti-inflammatory medication, steroids, physical therapy, and sometimes epidural injections to get you on the road to recovery.

“People think there’s nothing you can do [about arthritis] and they have to live with it. But there are medications and injections and surgery to replace joints.” —Dr. Dane Hansen, Summit Orthopedics

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Sleep

Six Clues You Might Need Snooze Solutions

It’s one of those health tips we all know and understand: getting seven to nine hours of sleep a night is vital to good health. Not only is it time for our brain and body to recharge, but sleep also plays a big role in preventing conditions like obesity, diabetes, heart disease, and high blood pressure.

And it’s not just length of time in bed—that sleep needs to be good quality. Even though we might be snoozing away for the right amount of time, it’s common to still feel tired the next day if sleep disorders are the cause. Specifically, you might be having breathing issues like snoring or obstructive sleep apnea. Dr. Kim Ledermann, a dentist at the Minnesota Craniofacial Center for TMJ & Sleep Treatment in St. Paul, shares five signs that you might be sleeping poorly.

1. LOUD SLEEPING

Snoring, gasping, or choking in your sleep often are signs of a sleep disorder. Consider seeing a sleep specialist if you wake up with headaches, sleep restlessly, are sleepy during the day, or your snoring is so loud that it disrupts your bedmate’s sleep.

2. LIGHT SLEEPING

Light sleepers might never settle into the deeper stages of sleep because of obstructive sleep apnea, Ledermann says. The airway’s soft tissues relax and can hamper breathing by completely or partially blocking the airway. The lack of oxygen shocks you awake, leading to shallower sleep.

3. 4. JAW PAIN OR DRY MOUTH

Nighttime clenching of teeth and breathing issues often go hand in hand. It’s a red flag for sleep disorders if you regularly wake up with headaches and jaw pain. Similarly, experiencing a dry mouth or throat most likely means you are mouth breathing, which is more prevalent in people with sleep apnea. 

5. NO PEACE OF MIND

Sleep troubles definitely mess with your head, often causing issues with memory and cognition and irritability, as well as anxiety and depression.

6. RESTLESS KIDS

About 1–4 percent of kids experience sleep apnea, too, but their symptoms differ from adults. Look for hyperactivity during the day and nighttime clenching and grinding their teeth, snoring, sweating, and bedwetting, Ledermann says.

A sleep physician will assess you with a sleep study, often conducted from the comfort of your own home, and identify a therapy to help. The gold standard treatment is a CPAP machine to regulate your breathing, but dental appliances also can work. Your mattress and pillow also matter. A bed and pillows that elevate your head are key, Ledermann says. So is a high-quality mattress that makes it comfortable to sleep on your side—the best position for mitigating sleep apnea.

LOCAL COMPANY’S SLEEP TECH GETS UNDER YOUR SKIN / BY JAMIE KORF

Sleep? Never heard of her, say the majority of adults these days. Sleep problems were ascending to historic heights pre-pandemic—now they’re so pervasive, they’re giving rise to a subcategory of sleep disorders besieged by buzzwords, like coronasomnia. The one thing that hasn’t changed, however, is the seriousness of obstructive sleep apnea (OSA). According to the Sleep Foundation, it’s estimated that it affects between 2 and 9 percent of adults in the U.S., though the majority of cases go undiagnosed.

“People with severe OSA experience an airway collapse every other minute during sleep,” says Tim Herbert, CEO and president of Inspire Medical Systems Inc., based out of Golden Valley. “These recurring collapses prevent a person from reaching deeper stages of restful sleep, which can lead to health issues like heart disease, hypertension, stroke, and even diabetes.” Add to that, OSA was identified as an independent risk factor for severe COVID resulting in hospitalization, according to recent findings by BMJ Open Respiratory Research.

Herbert and his team are determined to make their mark in the public health space with Inspire, a device that implants under the skin. When turned on via a small remote, Inspire monitors breathing and sends a pulse to gently move the tongue and open the airway each time the individual takes a breath. “When people decide to use Inspire, they are choosing a lifelong therapy that they use every night,” says Herbert. “The procedure takes two hours, and the patient is typically able to go home the same day.” The battery lasts for 11 years on average; the user’s doctor is able to make minor programming adjustments along the way to make the therapy as comfortable as possible.

The CPAP mask is still the gold standard in the sleep medical device market. Herbert says that Inspire is usually prescribed after a patient has been diagnosed with moderate to severe OSA and tried a CPAP to little success. “CPAP can be an effective therapy, but some patients are not able to benefit from long-term use of the device,” he says. This is due to many reasons, but chief among them is the struggle with being tethered to the CPAP device on a nightstand.

“In the future,” Herbert continues, “we will continue to grow and invest in new technologies to make Inspire even more effective ... including digital tools like Inspire Cloud, the Inspire Sleep app, and a Bluetooth-enabled patient remote to provide for distanced patient care.”

At this time, Inspire is the only FDA-approved treatment that works inside the body to treat the root cause of OSA.

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Pain

Four Reasons to See a Pain Specialist

People with chronic pain often feel like they have run out of options. Most have tried physical therapy, chiropractic care, acupuncture—maybe even surgery. Another option is to see a pain management physician who can help with coordinated therapies and treatments. Dr. Sherri Haas, a pain management physician at Twin Cities Pain Clinic, explains how to know when to see this specialist.

1. IT'S CHRONIC

Pain is normal after an injury or surgery, for about six weeks. Maybe it lasts a bit longer, but it’s slowly easing. “But persistent pain that won’t quit past the three-month mark is not normal,” Haas says. “At that point, the pain is now chronic and requires a different approach.”

2. IT'S PERSISTENT

When pain takes over and you struggle to handle activities of daily living, such as getting dressed, walking, or cooking, it’s time to get help, Haas says. Pain should not regularly interfere with your sleep, capacity to work, mental health, or ability to live your normal life.

3. SURGERY ISN'T AN OPTION

Sometimes the source of pain cannot be addressed through surgery, or you have decided against a procedure. A pain management physician can design other treatment options, such as steroid injections, procedures like radiofrequency ablation, or devices like spinal cord stimulators, Haas says.

4. YOU ARE CONCERNED ABOUT TAKING OPIODS

Medication is a key part of easing pain, but many people are wary of opioids. Pain management specialists have a deep understanding of options. They can prescribe different classes of medications or combinations of medications that ease pain while helping you limit or avoid opioids, Haas says.

“Persistent pain that won’t quit past the three-month mark is not normal. At that point, the pain is now chronic and requires a different approach.” —Dr. Sherri Haas, Twin Cities Pain Clinic

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Skin

Three Times You Should Always See a Dermatologist

Skin plays a big role in our health, acting as a sensor to the outside world and a barrier to germs, pollution, and radiation from the sun. When you have a concern, big or small, dermatologists want to see you. They work to identify and treat issues before they turn serious, says Dr. Erin Sellinger, a dermatologist at Zel Skin & Laser Specialists in Plymouth and Edina.

1. SKIN CANCER SCREENING

People in their 20s should see a dermatologist for a baseline skin cancer screening. Dermatologists recommend that you go annually or every few years, depending on your risk factors. High-risk people have a family history of skin cancer, numerous moles, frequent tanning bed use, or a history of blistering sunburns.

The 10–15 minute screening involves examining every part of your skin, often with a specialized light. Your dermatologist is looking for lesions, moles, or skin changes. They can biopsy the area right then and determine whether the suspicious skin contains cancer. “We would rather catch something when it’s highly curable,” Sellinger says.

2. ACNE ASSISTANCE

Acne affects about 85 percent of people at some point in their life. When over-the-counter medications don’t cut it, or when your skin’s color or texture changes after acne, it’s time to see a dermatologist. Physicians can prescribe medicated cleansers, creams, and pills to treat acne, prevent scarring, and improve the overall appearance of skin.

3. ITCHING FOR A DIAGNOSIS

Dermatologists also keep our hair, scalp, and nails healthy. Head in if you have significant itching, redness, and flakiness from dandruff that won’t go away with store-bought products. Your dermatologist can prescribe medicated shampoos, gels, or creams. If the dandruff isn’t responsive to OTC medicated shampoos, check with a dermatologist to see if additional treatments are needed and if there are signs of psoriasis, which is associated with other risk factors, Sellinger says.

“[Scalp psoriasis] should be diagnosed and treated because it often occurs with cardiovascular disease and psoriatic arthritis.” —Dr. Erin Sellinger, Zel Skin & Laser Specialists

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Eyes

Five Clear Signs It's Time to See the Eye Doctor

Seeing an eye care professional to have your vision checked should be a regular part of your health care routine. Then there are times when something isn’t quite right. You might notice changes, or your optometrist might identify concerning symptoms. They can either treat the problem or refer you to an ophthalmologist for a surgical consultation. Dr. Mark Hansen, an ophthalmologist at Minnesota Eye Consultants, identifies five indications that your eyes need to be checked.

1. VISION CHANGES

It could be a cause for concern if you are experiencing visual changes like blurriness, double vision, worsening vision, or trouble with night vision, or you see halos around lights, Hansen says. The time might have come for you to address your cataracts—a clouding of the clear lens in the eye. This will happen to everyone, usually in their 60s and 70s, and it’s solved by surgically removing the lens and inserting an artificial one.

Changes to your vision also can be a sign of conditions like macular degeneration, an age-related eye disease that blurs your central vision. Another possibility is that you are experiencing health problems like high blood pressure and uncontrolled diabetes, which an ophthalmologist can identify during an exam, Hansen says.

“When eye conditions like glaucoma and macular degeneration strike close to home, it’s important to be screened every year.” —Dr. Mark Hansen, Minnesota Eye Consultants

2. VISION CHANGES, THE SEQUEL

If you see flashing lights or a floater in your vision, you should see an ophthalmologist right away. These symptoms can indicate a retinal tear, hole, or detachment, and such conditions can be vision-threatening. “They are one of the few ophthalmologic emergencies that we take care of on nights and weekends,” usually with surgery or a laser procedure, Hansen says.

3. REDNESS

Red eyes can be caused by something as simple as allergies, but it also can stem from dry eyes or an infection. Commonly, the infection is viral or bacterial conjunctivitis, or pink eye. It also can be a less common symptom of glaucoma, a condition that damages the optic nerve and is one of the leading causes of blindness in adults.

4. EYE PAIN

Called “the silent thief of sight,” glaucoma presents with few symptoms. But peripheral vision loss is one sign that glaucoma might be progressing. Vision loss from glaucoma can’t be reversed, but it can be prevented if treated, Hansen says. An ophthalmologist will screen you for glaucoma at routine eye exams by checking the pressure in your eye. But if you are experiencing eye pain, make an appointment.

5. FAMILY HISTORY

When eye conditions like glaucoma and macular degeneration strike close to home—in siblings or a parent—it’s important to be screened regularly, Hansen says. People without that family history who are healthy and have good vision can be screened every few years.

IN A BLINK: Flashing lights or floaters can mean a retinal tear, hole, or detachment and be vision-threatening.

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Teeth

Six Things Your Dentist is Looking For

We know the drill: Every six months, it’s time to visit the dentist for a routine cleaning and screening. But what exactly are your dental hygienist and dentist looking for? Here is a behind-the-scenes look at a dental check-up.

1. TO THE (JAW) BONE

Dentists take x-rays to assess what’s going on under the surface, says Dr. Stacey Wolken of Park Dental Eden Prairie. She’s checking to see if your jaw bones look healthy and offer good support for your teeth. Dentists also use x-rays to find tooth decay in hard-to-see areas between teeth. And they are searching for abscessed teeth or jaw cysts, which are associated with impacted wisdom teeth.

2. GUM HEALTH

Healthy gums are a vital part of your oral and overall health. Puffy, red, or bleeding gums are a sign of gum disease, an inflammatory condition that can lead to other serious health concerns, like cardiovascular disease, diabetes, and some cancers. When your dental team starts reading off numbers, they are evaluating the overall health of the gum tissue and bone. Teeth with more advanced gum disease, meaning deeper bone loss, can lead to eventual tooth loss and might prompt more frequent cleanings or a trip to the periodontist, Wolken says.

3. CRACKS IN THE FOUNDATION

Your dentist checks your dental restorations, such as crowns and fillings, to make sure they are holding up. They also want to ensure that teeth aren’t cracking. This can happen from dental work, clenching and grinding, and chewing hard substances like ice, candy, and nuts, Wolken says.

4. HIDDEN CAVITIES

There’s nothing like an up-close look at teeth to find cavities on the surface. Dentists often identify cavities in places that x-rays can’t catch.

5. ORAL CANCER CHECK

When your dentist gets out the gauze and starts moving your tongue around, it’s for an oral cancer screening. They are searching for red or white patches and unusual lumps or bumps on the roof of your mouth, the back of your throat, your cheeks, and underneath and on the back of the tongue, Wolken says. It’s essential to catch oral cancer early because it has a high rate of spreading to other parts of the body.

6. BABY TEETH BITE CHECK

For toddlers to teens, dentists track the growth and development of their teeth and bite. They check to see that kids have enough space for their permanent teeth and assess whether to make room with early interventions, Wolken says. Dentists also diagnose clenching and grinding, which usually mean that kids are struggling to breathe because of large tonsils or other issues, like misaligned teeth, Wolken says.

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This article originally appeared in the February 2022 issue of Mpls.St.Paul Magazine.