WEST PALM BEACH, Fla. — Not that they'd care to admit it, but the nation's 78 million Baby Boomers are aging fast.
Lucky for them, medical advances are keeping pace. When Boomers were born, heart disease or cancer amounted to death sentences. Arthritic hips and knees meant years of limping.
Now, Boomers can live for decades after heart attacks or cancer. And knee replacements and hip replacements let patients walk as well as they ever did.
"We're at an exciting time," said Dr. Gene Shieh, a radiation oncologist at Jupiter Medical Center. "Computers and mechanical capabilities are catching up to the things previous generations of doctors wished they could do."
Boomers are an important market for doctors. And they're catering to their patients with these breakthroughs in care.
For breast cancer patients, a better way to rebuild
Dr. Martin Newman is an expert at reconstructing the breasts of women who lose a breast to cancer.
But even with his years of experience, Newman admits he never was completely sure which tissue to remove and which to leave. The problem nagged him, because making the wrong call can lead to complications such as pain, bleeding, infection and even the need for another operation.
A few years ago, Newman and his colleague, Dr. Michel Samson, had a brainstorm: The two Cleveland Clinic Florida plastic surgeons tried the laser used by heart surgeons to help with reconstruction.
"We saw them using it in the cardiac room, and we wheeled it down the hall," Newman said.
He trains the laser on the patient during surgery, and it reads blood flow and tells him which tissue to remove and which to keep. The result, Newman said, is a "remarkable" decrease in complications.
"The lasers seem to give us a clear-cut window into tissue viability," Newman said. "It tells us what's going to live and what's going to die. The ability of the laser to make that decision far exceeds the ability of the surgeon to make that decision."
The technique is novel enough that Samson and Newman have spoken at medical conferences throughout the world, and doctors in other parts of the country have begun to follow suit.
"We've really broken ground," Newman said.
A more precise knee replacement
Dr. Norman Palmeri says knee replacement is a lot like carpentry, and he doesn't just mean the part about drilling a knee-to-hip hole in the femur. He's also referring to the less-than-precise technique of aligning the new knee in the patient's leg.
"Basically, it's a lot of eyeballing," said Palmeri, an orthopedic surgeon in Port St. Lucie, Fla. "There's been a big emphasis on finding a way to make that more accurate."
Now comes a high-tech method for replacing knees that removes the guesswork. Before surgery, Palmeri orders an MRI of the patient, which is sent to the factory of California-based OtisMed. The company's computers make a custom kit designed to fit the patient's leg.
Palmeri said patients are recovering more quickly and feel more flexible.
OtisMed's technology means he no longer must drill a hole in the patient's femur or install a 2-foot rod to hold the new knee in place. And because the computer has decided how to align the artificial joint, there's no need for eyeballing.
"The results are amazing in terms of how fast they get better," Palmeri said.
'Neurosurgery in a needle'
An hour ago, Arnie Goldberg couldn't turn his head without pain. Half an hour ago, he winced as Dr. Lawrence Gorfine inserted five needles into his neck near his right ear.
And now, he swivels his head from side to side as he sits in a post-operative bed in Gorfine's office.
"I have no pain," Goldberg tells Gorfine. "It's like a miracle."
Gorfine is an enthusiastic proponent of a procedure he calls "neurosurgery in a needle." Through thread-thin needles like the ones inserted in Goldberg's neck, Gorfine uses radiofrequency — a 180-degree blast of high-intensity sound waves — to deaden nerves in inflamed areas.
The result? The patient can turn his head without pain. The effects last for nine months to a year, until the burned nerve endings grow back and begin registering pain again.
Gorfine recommends the procedure to patients who suffer chronic neck pain that doesn't respond to cortisone shots. Some of his patients have been hurt in car wrecks or workplace accidents. Others are simply suffering the inevitable deterioration of the neck, which can begin in the late 40s or early 50s.
Goldberg, 82, blames today's pain on the falls he suffered as a polo player in his younger years.
Gorfine says there's little downside to the radiofrequency procedure. But, he acknowledges, it does nothing to heal damaged disks.
"One day, stem cells are going to be the answer — maybe," Gorfine says.
Using patient's own blood to avoid surgery
The hottest development in sports medicine is surprisingly low tech. It involves little more than injecting scarred tendons or damaged ligaments with a patient's own blood.
The procedure is known as platelet-rich plasma, or PRP, and Dr. David Westerdahl of Cleveland Clinic Florida's West Palm Beach office has tried it on a few patients in the past month, including a member of Florida Atlantic University's football team.
PRP got a boost this year when Pittsburgh Steelers receiver Hines Ward sprained a ligament in his right knee. After a PRP injection, Ward caught two passes in Super Bowl XLIII.
Here's how it works: Westerdahl takes a small syringe of blood from the patient, then spins the blood in a centrifuge for 15 minutes, a process that separates blood platelets from red blood cells. The spinning yields a teaspoon of platelet-rich plasma.
Westerdahl then injects the PRP into the injured area. While scientific evidence remains sketchy, the experience of athletes like Ward convinces doctors that PRP stimulates healing.
PRP is best-suited to athletes who suffer some muscle or ligament injuries or chronic tendinitis such as tennis elbow, plantar fasciitis, Achilles tendinitis or patellar tendinitis. Westerdahl recommends the procedure to patients whose pain hasn't responded to ice, stretching, physical therapy or a cortisone shot.
For most people, he sees PRP as a last shot before the operating table. Insurers don't cover the procedure, which costs about $1,000. Westerdahl calls PRP a low-risk procedure for patients who'd prefer to avoid the cost and possible complications of surgery.
Hearing aids as fashion accessories
Hearing aids are getting a makeover — just as Baby Boomers feel the effects of all those Bruce Springsteen and Rolling Stones concerts. Experts say millions of Americans have hearing loss that goes untreated, in part because of the none-too-hip reputation of hearing aids.
But the latest devices not only work better but include features such as Bluetooth software that connects with cell phones and iPods, said Dr. Cindy Beyer, senior vice president at HearUSA, a West Palm Beach-based company that runs hearing centers.
And the hearing aids that cover the entire ear opening no longer are as common as they once were. Today's hearing aids go behind the ear and are connected to a thin tube that goes into the ear.
"They really are very inconspicuous," Beyer said.
But for those who want to embrace their hearing aids as fashion accessories, it's possible to buy tubes in a variety of colors. There's even a leopard print.
Jeff Ostrowski writes for The Palm Beach Post. E-mail: jeff(underscore)ostrowski(at)pbpost.com.