MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

As seen in the Odessa American “Medical Matters”:


MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury
by Dr. James Ingram

Dr. James Ingram is a Board Certified Orthopedic Surgeon and specializes in Sports Medicine.

“I saw my Doctor about my shoulder pain. He took an X-ray and told me ‘nothing is wrong’.”

A more appropriate response would have been, “there’s nothing broken”. Most sources of shoulder pain are not obvious on an X-ray. The shoulder is a remarkable joint with more movement than any other joint in our body. Thus, diagnosis of the specific cause of pain in the shoulder can be difficult.

The earliest signs of arthritis in the shoulder typically appear in the joint connecting the collar bone to the shoulder blade (acromio-clavicular or AC joint). In the absence of injury, this joint can show signs of arthritis on x-ray as early as age twenty-five. Pain associated with this joint is increased with lying on the side, using the arm at shoulder height or higher, pulling things toward you or away from your body. The pain does not make motion impossible but the use of the shoulder increases the pain.

Rotator cuff tears may be partial or complete. Risk factors for rotator cuff problems include male gender, high blood pressure and elevated cholesterol. Trauma is also a major cause, fall on shoulder or outstretched hand, shoulder dislocation, lifting or pulling heavy objects. Partial tears are more painful, full thickness tears result in loss of motion and weakness. Many partial tears do not require surgery. Full thickness tears will not heal without surgery. But with therapy, the patient may regain an acceptable motion and use, depending on the patient’s needs.

A cartilage ring surrounds the socket of the shoulder. This cartilage ring, the rotator cuff and the joint capsule provide a stable joint with an extensive range of motion. Tears of this cartilage ring cause pain and mechanical symptoms. They usually result from shoulder dislocation or an unexpected pulling injury to the arm. The bicipital tendon, one of two tendons to the bicep muscle is attached to this cartilage ring. Tears of the bicipital tendon are common. Usually the result of lifting heavy objects. Tears of this tendon usually do not require surgery. The patient will lose ten to fifteen percent of strength bending the elbow. A cosmetic deformity of the bicep contour will occur, but does not contribute to significant weakness.

The shoulder joint contains cartilage and is prone to developing arthritis. The onset is gradual. Primary complaint is pain. As the arthritis becomes more severe the patient will eventually lose motion. The pain is described as constant, increased with use and many times associated with painful catching and grinding.

Another frequent source of “shoulder pain” is actually referred from the neck. The patient’s neck may not hurt! The pain is typically in the back of the shoulder blade. The majority of time, the pain will go below the elbow sometimes causing numbness and tingling in the fingers. Pain that is solely due to a shoulder problem may go to the elbow but not below. Unfortunately, having an injured shoulder does not mean you don’t also have a neck problem, and vice versa.

The key to minimizing shoulder pain lies in maintaining muscle fitness not only the rotator cuff, but the muscles that stabilize your shoulder blade. The shoulder allows us an incredible ability to perform complex tasks. Shoulder pain consequently can be a source of severe dysfunction.



MEDICAL MATTERS: Good Nutrition is Vital for Pregnancy

MEDICAL MATTERS: Good Nutrition is Vital for Pregnancy
As seen in the Odessa American “Medical Matters”:

by Dr. Avelino Garcia

Good nutrition is vital for a healthy pregnancy. Between fatigue and pregnancy cravings, it can seem difficult to keep healthy eating habits. Planning healthy meals and staying physically active can help.

Eating five or six small meals daily, rather than three large meals, can help with nausea and can also help pregnant women get extra vitamins and minerals needed for growing babies. Each day, eat foods from the major food groups, keeping fats and sugars in moderation. Fresh fruits and vegetables, whole grains and lean proteins are encouraged. Be sure that red meats are fully cooked, not rare, as this can cause illness in a pregnant woman. Fish and seafood are good sources of protein, but stay away from seafood with high mercury content such as shark, swordfish, king mackerel or tilefish. Limit white (albacore) tuna to 6 ounces weekly.

Hydration is also a key part of proper nutrition. Pregnant women are encouraged to drink at least two liters of water daily. Symptoms of dehydration in pregnancy include thirst, headache and uterine cramping. Sugary and caffeinated drinks increase risk for dehydration, so they are to be avoided.

Staying physically active is one of the healthiest things an expectant mom can do for her unborn baby. Thirty minutes of low intensity exercise, like walking, is encouraged.

Unless an expectant mother has a high-risk pregnancy, exercise can help regulate blood sugar levels, keep blood pressure in the normal range, and minimize abnormal weight gain.

The United States Department of Agriculture has made meal planning easier by creating The website assists everyone, including pregnant women, figure out how to make healthy choices with each meal. According to the American College of Obstetricians and Gynecologists (ACOG) Frequently Asked Questions (FAQ) on Nutrition During Pregnancy, the MyPlate website gives “personalized nutrition and physical activity plans by using the ‘Super Tracker’ program. This program is based on five food groups and shows the exact amounts needed each day from each group during each trimester of pregnancy.”


MEDICAL MATTERS: It’s just allergies … or is it?

MEDICAL MATTERS: It’s just allergies … or is it?
As seen in the Odessa American “Medical Matters”:

by Dr. Kevin Benson

Allergies seem to be a big part of our lives here in West Texas. It seems that no matter what the season, or the symptoms, people tend to think it’s their allergies. Or is it? Does it matter?

Environmental allergies are the body’s excessive response to things we need not respond too. For example, pollen is not really a threat to me, but my body responds to it in unhelpful ways. My nose fills with mucous, my eyes get red and itchy, that familiar cough makes its annual return. How do I know it’s my allergies versus a cold I may have been exposed to?

History: Seasonal allergies are just that, they occur at certain seasons. Everyone with allergies is a bit different, but most of us can predict the seasons where we will have trouble. Pollen allergies tend to be in the springtime, fall allergies tend to be more mold and mildew sensitivities, winter allergies are often caused by dust or dust mites blowing around as we turn on our heat. So with experience we know when it’s more likely to be allergies than a viral illness. And also why it’s difficult to know in a baby or young child, since they haven’t had as many seasons of experience to know how they respond to those environments.

Duration: Allergies can linger for weeks, sometimes months. It is very unusual for a cold to last more than a week or two. Sometimes we can be fooled though, as we or our children are recovering from one illness and fall into the trap of another illness; what feels like one illness can be a few separate ones. However, it is common to have one viral infection after another, especially in the wintertime.

Fevers: Allergies do not cause fevers. Fever is the body’s natural response to infection, and allergies are not an infection. However some people will develop secondary infections due to allergies; for instance the congestion caused by seasonal allergies can trigger ear infections or sinus infections. That is why it is always a good idea to treat those allergic symptoms as soon as possible, to prevent them from becoming something more serious.

Remember to use your judgment. If you’re not sure if you or your child has a cold or allergies and the symptoms are getting worse, changing or not improving, there’s no harm in consulting with your medical practitioner. When in doubt, check it out!


MEDICAL MATTERS: Preserving your hips and knees

As seen in the Odessa American “Medical Matters”:

by Dr. James Ingram

Time takes a toll on our bodies and our weight bearing joints and cartilage are no exception. Watching a youngster spring up from a sitting position at the speed of a slingshot reminds us all of the creaks and squeaks of our aging joints. However, you can take control and slow Father Time with a few key non-operative interventions.

Decreasing weight through exercise has a dramatic effect reducing wear and tear on hips and knees. Just to name a few, it improves circulation and cardiovascular health; helps the management of blood sugar; preserves and maintains joint cartilage. Low impact exercises are key. Stick with cycling, swimming or elliptical and stair stepping machines. The benefit of low impact exercise in addition to weight loss, is a reduction of shear force on weight bearing joints, minimizing cartilage loss and improving flexibility.

Supplements have a huge following but no supplement has FDA approval. Of all the supplements, the only one shown to minimize cartilage loss was Glucosamine. When trying supplements, I suggest avoiding ones with multiple ingredient, ie. Glucosamine, Chondroitin, MSM. If you have an untoward reaction with a multiple ingredient supplement, it’s virtually impossible to determine which ingredient did not agree with you. I recommend starting with Glucosamine because it’s the only one proven to be effective.

Support braces that unload the joint showing signs of wear is another intervention worth consideration. Two options are available; off-loader braces, or lateral wedge orthotics. Off-loader braces are bulky where lateral wedge orthopedics are more discretely worn. Although purely mechanical, both unload the burden to tired joints.

Anti-inflammatory, biologicals and injectable are pharmaceutical approaches to joint health. Non-steroidal anti-inflammatory drugs (NSAIDs) were the corner stone for osteoarthritis and rheumatoid arthritis until biologicals (Embrel, Humira, etc.) were developed. Over-the-counter or prescribed NSAIDs are still extremely effective but create cardiovascular risks, elevate blood pressure, can cause stomach ulcers, and even kidney failure. Injectable intervention falls into two categories; cortisone and injectable viscosupplementation. Cortisone injections have been around for decades and provide rapid but short term relief. They also exhibit side effects therefore should be used in moderation. In my practice, no more than once a quarter. Injectable viscosupplementation (“rooster shots”) are injections of a protein normally found in our joints and make a cushion to replace cartilage while improving the viscosity of joint fluid. These injections are performed in an office environment on a weekly basis for a period of 3-5 weeks.

Utilizing these recommendations will hopefully make your interaction with your orthopedic surgeon a social visit rather than professional.




Baby Teeth and Babies’ Teeth

 Baby Teeth and Babies’ Teeth

by Dr. Robert Stanaland

Baby teeth are so important! This cannot be stressed enough. Yes, they will be “lost” eventually, but they play a vital role in a child’s jaw development in addition to aiding in proper nutrition and socially.  Here are the answers to several questions we hear a lot.

When should I start brushing my baby’s teeth?

As soon as you are aware that any have erupted. Even before teeth come, you can be wiping down your baby’s mouth with a damp cloth after every feeding.

Why are baby teeth so important if they just fall out?

Obviously, children use their teeth to chew food, just like the adults. The baby teeth also act as place holders for the adult teeth, and if they are lost too soon, the adult teeth will have huge problems coming in correctly. Teeth that get decay can cause severe pain and infections. Children miss a lot of school in order to deal with dental problems, and the cost of treating these dental problems far outweighs the cost of preventing them. 

When should I take my child to the dentist?

It is recommended that a child be seen by age one (1) or within six (6) months of their first tooth erupting, but the child should have been in a dental office long before then. Expecting mothers should be seeing their dentist regularly before the child is here, so education begins then.

What else can I do for my kid’s teeth?

Take care of YOUR teeth! See a dentist regularly. If you have established good oral hygiene and diet habits, your children will too. “Bad teeth” are NOT inherited, but bad habits can be passed down to your children.

Dr. Robert Stanaland is a dentist at the Family Health Dental Clinic at
840 West Clements in Odessa, TX. (432) 332-8870

MEDICAL MATTERS: It’s blood pressure 102

MEDICAL MATTERS: It’s blood pressure 102

As seen in the Odessa American “Medical Matters”:

by Dr. Fernando Boccalandro

In my first article I discussed the basics of blood pressure and the definition of normal blood pressures values according to current guidelines. In this second article I will address some practical tips and tricks, to maintain an adequate blood pressure control.

Blood pressure tends to fluctuate due to multiple factors that affect the blood pressure including stress, level of activity, salt intake, fluid intake, etc. For my patients the goal is to keep their average blood pressure within normal levels over time, rather than focus on one, or another individual blood pressure number specifically. Think about the average of the blood pressures as the number to go by.

What are my pearls of wisdom for our readers, after diagnosing and treating hundreds of patients with elevated blood pressure?

  1. Know your numbers:Make sure that you measure and know what your blood pressure is, at least once or twice a year if you do not have hypertension. It is useful to have an automated blood pressure machine at home, especially if you are prescribed blood pressure medications to assure is well controlled. Bring your blood pressure machine to your appointments; to make sure is well calibrated and you blood pressure measurements.
  1. Do your homework:Keeping a diet low in salt (less than 2 grams of sodium a day), a healthy weight, decrease levels of stress and regular moderate exercise (at least 150 minutes weekly), can contribute to lower your blood pressure and will make you feel better. Take your medications as prescribed and do not discontinue your blood pressure medications without discussing it first with your healthcare provider.
  1. Plan for the long term:Hypertension in the majority of patients is a chronic disease, like diabetes, high cholesterol, etc. So plan for a lifetime commitment to monitor and control your blood pressure, it is well worthwhile to prevent any adverse consequences of uncontrolled hypertension.
  1. Get the best team:Successful blood pressure management is teamwork. It is important to involve your family to help you succeed in this lifetime goal if you have elevated blood pressure. And it is very important to be in close contact with your health care professional, to coach and advise you regarding goals and optimization of your blood pressure levels over time.

Don’t let your guard down with high-blood pressure! And please contact your primary care doctor if you have questions or concerns about your heart health.


Prostate Cancer Awareness Month

Prostate Cancer Awareness Month
by Maria Scott, MCHS Community Health Nurse Navigator

September is Prostate Cancer Awareness Month. Please take a moment to learn a bit more about prostate cancer as well as the risks, screenings and treatments associated with it.

What is prostate cancer?

Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer.

What is the prostate?

The prostate is a gland found only in males. It makes some of the fluid that is part of semen.

The location of the prostate is below the bladder and in front of the rectum. Because the size of the prostate changes with age, the walnut size found in younger men can be much larger in older men. 

What are the most common prostate problems?

Prostatitis is swelling and inflammation of the prostate gland, often causes painful or difficult urination. Although Prostatitis is more common in men over 50 years of age, it can affect men of all ages.

Benign Prostatic Hyperplasia, or BPH, is when the prostate is enlarged but not cancerous. It is very common in older men.

Prostate Cancer begins when cells in the prostate gland start to grow uncontrollably.

What are the risk factors?

Age – Prostate cancer is rare in men under the age of 40. The chance of a man having prostate cancer rises rapidly for men over the age of 50. About six of every ten prostate cancer cases are found in men older than 65.

Race/Ethnicity – Prostate cancer occurs more often in African-American men and in Caribbean men of African ancestry than in men of other races. African-American men are also more than twice as likely to die of prostate cancer as white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites.

Family History – The fact that Prostate Cancer seems to run in some families suggests that there may be an inherited or genetic factor in some cases. However, most prostate cancers occur in men without a family history of it.

Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.

Can prostate cancer be prevented?

There is no sure way to prevent prostate cancer due to the fact that many risk factors such as age, race, and family history cannot controlled. Additionally, according with the American Cancer Society the effects of body weight, physical activity and diet on prostate cancer risk are not clear. However, in order to lower your risk of prostate cancer, the following things should be considered that might lower your risk:

  • Eating at least 2½ cups of a wide variety of vegetables and fruits each day.
  • Being physically active
  • Staying at a healthy weight

What tests can detect prostate cancer early?

Screening is testing to find cancer in people before they have symptoms. For some types of cancer, screening can help find cancers at an early stage, when they are likely to be easier to treat.

Prostate cancer can often be found before symptoms arise by testing the amount of prostate-specific antigen (PSA) in a man’s blood. Another way to find prostate cancer is the digital rectal exam (DRE), in which the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland.

At this time, the American Cancer Society (ACS) recommends that men thinking about getting screened for prostate cancer should make informed decisions based on available information, discussion with their doctor, and their own views on the possible benefits, risks and limits of prostate cancer screening.

The MCH 123 on Prostate Cancer

  1. One in seven men will be diagnosed with prostate cancer.
  2. Get a PSA test beginning at age 50.
  3. Early detention is the key!

Sources: America Cancer Society and National Cancer Institute

I’m too tired to get up!

“I’m too tired to get up!”
by Pediatrician Dr. Kevin Benson

It’s a phrase that many of us parents hear on those school mornings.

It is an age old example of cause and effect, stay up too late and pay for it the next morning. Many adults try to beat the system with caffeinated beverages every AM but those things are not recommended for our kids (and probably aren’t really good for us in the long run either).

How much sleep do my kids need?  The National Sleep Foundation provides the following chart:

Age Recommended May be appropriate Not recommended

0-3 months


14 to 17 hours 11 to 13 hours

18 to 19 hours

Less than 11 hours

More than 19 hours


4-11 months


12 to 15 hours 10 to 11 hours

16 to 18 hours

Less than 10 hours

More than 18 hours


1-2 years


11 to 14 hours 9 to 10 hours

15 to 16 hours

Less than 9 hours

More than 16 hours


3-5 years


10 to 13 hours 8 to 9 hours

14 hours

Less than 8 hours

More than 14 hours

School-aged Children

6-13 years


9 to 11 hours 7 to 8 hours

12 hours

Less than 7 hours

More than 12 hours


14-17 years


8 to 10 hours 7 hours

11 hours

Less than 7 hours

More than 11 hours

Young Adults

18-25 years


7 to 9 hours 6 hours

10 to 11 hours

Less than 6 hours

More than 11 hours

As anyone care see, the recommended hours of sleep are always more than we expect.

Ways to improve sleep (especially with school starting):

  • Start bedtimes earlier. Avoid dramatic changes, if you’ve let the children stay up a little later during the summer, start weaning bedtime back to acceptable times by 15 minutes each night until you are back in the zone which provides adequate sleep.
  • Stop electronics at least an hour before bedtime. TV, video games, texting, etc are stimulating to the brain and make it more difficult to fall asleep.
  • Establish a bedtime routine. Routines make most of us feel more relaxed and doing the same thing before going to sleep helps us prepare for a more restful night.  Bathing, reading, praying can all be part of a family sleep routine.
  • Eat right! Avoid caffeine and sugar before bed; kids are less likely to “bounce of the walls” without the stimulation of many carbonated beverages and the quick energy boosts of high calorie snacks and desserts.
  • It’s always easier to sleep when you are physically tired.
  • Maintain consistency. Many kids stay up late on weekends and then drag through Mondays and Tuesdays, start to feel better by the hump of Wednesday and then repeat the whole thing again as the weekend comes.  Maintaining bedtimes AND awakening times during the weekend will tend to help those who struggle on those dreaded blue Mondays.

Following these guidelines will make getting back to school a little less stressful for you and your family.

Kevin Benson, M.D., Board Certified in Pediatrics who specializes in:

• Comprehensive Pediatric Care
• Care From Birth to age 18 (Newborns/Infants/Toddlers/Adolescents)
• Allergy & Asthma Care Referrals
• School, Sports, Camp Physicals
• Sick Child Visits
• Routine Wellness Exams
• Health Education
• Immunizations

MCH Family Health Clinic 6030 West University Odessa, TX 79764
Office Hours: Monday – Friday: 8:30 am – 5:30 pm
Same Day Appointments Available Call (432) 640-6600 for more information or to make an appointment.

Preventing Tooth Decay at Work

Preventing Tooth Decay at Work
By Dr. Robert Stanaland, Doctor of Dental Surgery at ProCare Family Health Dental Clinic

Regardless of your background, tooth decay, or dental caries, can affect everyone. People are vulnerable during the work day for several reasons. First, they are away from home, which is where their toothbrush and floss are. Secondly, they are busy with work and probably are not aware of their habits that facilitate dental caries. And third, they are not knowledgeable about how dental is caused.

  • Dental caries is caused by oral bacteria that metabolize (digest) a wide variety of sugars. The metabolism lowers the pH of the mouth, causing it to become more acidic.
  • Limit the time you are consuming sweetened foods, particularly liquids. Sipping on sweetened coffee or soft drinks after breakfast or lunch can feed caries-causing bacteria for long periods of time, causing your mouth to be acidic.
  • Brushing your teeth after a meal is not the best strategy to prevent decay. This only allows you to brush away weakened enamel, the outside part of your tooth. (The enamel is weakened by the acids produced by bacteria after meal.)
  • Chewing sugarless gum for 10 minutes after a meal will stimulate saliva production. Saliva is your best defense against tooth decay. It neutralizes acids among other things.
  • If you plan to use a mouth rinse after a meal, use one with fluoride. This helps to make your teeth less vulnerable to decay.

Robert Stanaland, D.D.S. 
Doctor of Dental Surgery
840 West Clements • Odessa, Texas 79763
(432) 640-4860

Keeping Eyes Young

Keeping Eyes Young

by Dr. G. Chase Jackson O.D.

Keeping your eyes young and having great vision for years to come is an ideal sought by the masses. Here are some ways I address these concerns with my patients daily.

Cataracts are an eye condition that will happen to everyone fortunate to live long enough. Many lifestyle choices will determine how soon and how quickly the condition will affect you. If you have cataracts, you may notice decreased vision, glare or halos around lights, reduced night vision, or difficulty driving especially at night.

Whether you have been diagnosed with cataracts or not, there are ways to delay the onset and progression of this condition. Every day, patients of mine are interested in discussing cataracts and how to decrease progression. Allow me to share some highlights from our discussions.

Condition and Symptoms:

Cataracts occur within the lens of the eye. The lens is clear and located directly behind the iris, the colored part of the eye. Over time, this clear lens becomes yellow and rigid causing vision to decrease. When this happens, glasses will be less able to improve vision.

Sun exposure, smoking, more birthdays, and a handful of medical conditions can contribute to cataract occurrence and progression. Generally cataracts progress slowly over many years. But some patients, especially those with diabetes, can experience progression much more quickly.


Now that we know more about cataracts, we can take logical steps to decrease their onset and progression. Avoiding risk factors such as unprotected sun exposure, eye trauma, and smoking, will greatly decrease risk of cataracts. In other words if you wear sunglasses with UV protection, use protective eye wear with sports, and avoid smoking, your risk of acquiring cataracts early will greatly decrease. Doing these things will keep your eyes young and seeing well for extra years to come.

If you have any medical conditions – particularly diabetes, or if you take steroids, it is very important to get your eyes examined. Your eye doctor is able to work closely with your other doctors to ensure your eyes remain healthy along with the rest of your body.

Cataracts do not improve without eye surgery. Following these guidelines will help ensure your eyes provide you great vision without requiring early cataract surgery

If you are concerned that you or a loved one may have cataracts, you can make an appointment to see Dr. Jackson by calling 432-640-6600.

Chase Jackson, O.D.
Board Licensed Optometric Glaucoma Specialist and member of the American Optometric Association

Chase Jackson, O.D. is a Board Licensed Optometric Glaucoma Specialist. He received his Doctorate Degree from the Arizona College of Optometry and specializes in primary and secondary eye health care. Moreover, Dr. Jackson is an Adjunct Faculty Professor of Ophthalmology at the Texas Tech University Health Sciences Center. His services include state of the art eye examination, diagnosis, treatment and management of a wide range of eye diseases and pathologies, including:

  • Diabetic Eye Care
    • Glaucoma
    • Macular Degeneration
    • Eye Trauma Management
    • Cataract Surgery co-management
    • Pre/Postoperative Laser Eye Surgery Management
    • BioTissue Corneal Wound Care
    • Eye Exams for all Ages
    • Medical Eye Exams
    • Exams for Glasses and Contact Lenses

Center for Primary Care – West University
6030 West University • Odessa, Texas 79764

Office Hours:
Monday – Thursday: 8:00 am – 5:30 pm, Friday: 8:00 am – 5:00 pm

Phone: (432) 640-6600