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Aging baby boomers want to live active lives, require innovations in medical treatment

Published: Sunday, April 14 2013 2:15 p.m. MDT

Jim Dickson recovers from shoulder reconstruction surgery at Lakeview Hospital in Bountiful on Thursday, April 11, 2013. Dickson had peripheral nerve blocks applied before the surgery to help with the pain.

Kristin Murphy, Deseret News

BOUNTIFUL — The baby boomer generation is aging, and a large portion of the growing 65-and-older population isn't going quietly into a sedentary retirement.

Many are requiring joint replacement surgery, as they intend to remain active until the bitter end, according to Dr. John Edwards, an orthopedic surgeon who specializes in knee and shoulder replacement surgeries at MountainStar Healthcare's Lakeview Hospital.

"People are more active and they're more active for longer," Edwards said, "and as a result, they don't want to have pain associated with their joints."

With the population of retirement-age people in the state expected to increase by 126,700, or 51 percent, between 2010 and 2020, doctors are applying procedures such as the peripheral nerve block prior to joint replacement surgeries to reduce pain and recovery time.

Utah has the sixth fastest growth rate in the nation for people age 65 and older, according to a Utah Department of Human Services report. Doctors expect the number of surgeries to continue to climb with the aging population.

Edwards said hip, knee and shoulder joints can wear out with age, resulting in sometimes debilitating pain and the inability to move as once was possible, which can be frustrating for someone wanting to remain active.

With available medical technologies, as well as the desire of more people to be active and healthy throughout life, Edwards said many are turning to surgery to replace these aching joints.

And those seniors considering orthopedic surgery are now told that their pain level during surgery and recovery can be dulled with the help of a presurgical procedure practiced by most major hospitals and some smaller community facilities in the state, according to Lakeview anesthesiologist Dr. Tory Hinkle.

"We really use them every day," Hinkle said.

Lakeview Hospital has been ranked first in the state for the number of orthopedic surgeries it offers as well as the quality of service provided for the past three years, and it is among America's 100 Best Hospitals for orthopedic surgery, according to a Healthgrades annual report.

It is procedures like the peripheral nerve block that makes them a desirable option for the population needing surgery.

Peripheral nerve blocks, Hinkle said, can reduce the time patients spend in the hospital following a joint replacement surgery, provide a pain-free sleep during the typical post-surgery stay, and enhance their recovery process. It's not necessarily new treatment, but it has advanced over time.

"We've been doing this for years," Hinkle said. "The new part is the ultrasound technology that we are using has come a long, long way. We can see the nerves on the screen; see where the needle comes into the body. We can avoid any kind of blood vessels."

The procedure, he said, used to involve a cumbersome table and computer that provided a sometimes indecipherable image, which made correct placement of the anesthetic more difficult.

A nerve block involves numbing the nerves nearest to the surgical site with a local anesthetic to last during the most intense pain period, which typically covers the entire first 24 hours after surgery, allowing the body to focus on healing rather than the pain. It provides an alternative to general anesthesia.

"These blocks make it great on the patient," Hinkle said. "It's a lot easier, takes away a lot of stress to the body, so you don't feel that pain. … Also, they don't have to take as much anesthetic so they feel much better."

The nerve block also reduces the need for potentially addicting narcotic pain medications during and throughout the surgery, recovery and rehabilitation periods, which both doctors said is a tremendous advantage, given the growing number of prescription drug-related problems in Utah.

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