Perimenopause: What to Expect

Menopause is something that all
women are aware of and probably
think about occasionally...

read more

Save a Life:
Know the Signs of Stroke

Every year, nearly 800,000 Americans
experience stroke. While some stroke
patients die, others will live...

read more

Keeping Your Kids Healthy During
Cold and Flu Season

It's that time of year parents
everywhere dread - the season
for colds and flu...
read more

Heal Your Hands: How to Know What Your Hand Symptoms Mean

You hear the chime
of a text message and soon
your fingers are...

read more

Heal Your Hands: How to Know What Your Hand Symptoms Mean

By Robert Slater, MD, FACS

You hear the chime of a text message and soon your fingers are flying, sending a response shooting back? You're rushing to get your kids ready for school and your hands quickly transform your daughter's mop of hair into two perfect braids... You're whipping up dinner and using one hand to stir a pot and the other to grab ingredients out of the cabinet... Think of all the work your hands do during the course of the day. Is it any wonder that they ache every now and then? So how do you tell when that ache is something more serious? Below are a few common hand ailments - see which describe what you're feeling.

Arthritis: Arthritis of the hand and wrist joints is quite common. The joints most often affected by osteoarthritis (a degenerative or "wear and tear" type of disorder) are the finger joints closest to the fingernails and the joint at the base of the thumb; all are treatable by a variety of means, including surgery in some cases. Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder and is much less common than osteoarthrosis (OA). RA often affects multiple joints in the body and both hands symmetrically.

Carpal Tunnel Syndrome: Compression of the median nerve, a major nerve in the hand, is the fundamental cause of carpal tunnel syndrome (CTS). Common symptoms include numbness, tingling, and pain, typically limited to the in the thumb, index and long fingers. As the condition progresses, it can lead to muscle weakness and atrophy. Treatment may include splinting, medications or surgery to relieve the excess pressure on the nerve.

Dupuytren's Contracture: This disorder is a genetic disorder that usually presents later in adult life and its hallmark is the formation of dense cords of tissue in the palm and fingers, just beneath the skin. The cords cause finger contractures and interfere with hand function because it prevents straightening the fingers or putting the affected hand flat on a table. When bothersome enough, the diseased tissue can be broken up with an enzyme injection as an office procedure or removed with surgery.

Ganglion Cysts: These semi- soft "bumps" typically occur on the back of the hand near the wrist joints, although they can occur elsewhere, too. The "bumps" are filled with a jelly-like substance that bubbles out from the involved joint. Often they are painless but if they grow large they can tender and may even limit wrist movement. Sometimes the cysts "pop" and disappear on their own. If they don't, they may be amenable to drainage with a needle by your doctor.

Tendonitis: Tendons connect muscles to bones so that contraction of the muscle generates a force to move the desired bone or joint. When tendons become inflamed, they hurt, and that is what is meant by tendonitis. Overuse or sudden change in activity level and sometimes forceful, repetitive motions can cause the tendons of the hand to become inflamed and painful. In most cases, rest, ice and splints can be used to treat tendonitis in the hand, or an injection of steroid or even surgical procedures may help.

This common disorder occurs when the sheath through which tendons pass becomes thickened or irritated. The finger may get locked in one position, making it difficult to bend or straighten the involved joints. Risk factors for trigger finger include diabetes, gout and rheumatoid arthritis, but more often it happens for no specific reason.

Whatever your hand ailment may be, it is important to pay attention to it. If pain does not go away with rest and activity modification, contact your physician.

If you think orthopedic surgery may be the solution for your pain, call Dignity Health Orthopedics Sacramento at 916.851.2110 or schedule a consultation today.

Return to top

Keeping Your Kids Healthy During Cold and Flu Season

It's that time of year parents everywhere dread - the season for colds and flu. Whether your child spends his days in school or at daycare, chances are he will come home with several different illnesses through the course of this winter. But good news - there are simple steps you can take to help your child spend more days healthy and fewer days sidelined with sickness.

First - and most importantly - everyone in your family should be vaccinated against the flu. According to the Centers for Disease Control (CDC), influenza is a contagious respiratory disease that infects the nose, throat and lungs and can lead to serious complications, hospitalization, or even death. Flu-related complications can include pneumonia and bronchitis. Anyone can get sick from the flu and spread it to friends and loved ones. The best protection is a flu vaccine - either the flu shot or the nasal spray. The flu shot is approved for use in people older than six months, including both healthy people and those with chronic medical conditions. The nasal spray vaccine is approved for use in healthy people (those without chronic conditions like asthma) age two through 49 years who are not pregnant.

Other than getting a flu vaccine, the best protection against illness is hand washing. Cold and flu viruses are not airborne - in order to contract these illnesses, you must come into contact with a contaminated surface (doorknob, keyboard, toy, etc.) and then rub your eyes or touch your nose or mouth. That chain of infection can be broken by washing your hands. Teach your children to wash their hands frequently with soap and water, particularly before eating, after using the restroom and after being in a public place. Hand sanitizer can work too, although soap and water is preferred.

Also - teach your children to use tissues to blow their nose and to cough and sneeze into a tissue or their crook of their elbow. When illness is rampant, avoid sharing food, drinks, utensils or wash cloths - even within your own family.

Finally, help your children develop strong immune systems by keeping them well fed and well rested. A healthy diet of protein, fruits, vegetables and carbs provides valuable nutrients that can help fight off infection. And while a multi-vitamin is a nice supplement, it should not replace a well balanced diet. Sleep is also a powerful tool in everyone's infection-fighting arsenal. Although every child is unique, toddlers/preschoolers typically need 11-13 hours a night, young school-age kids need 10-11 and pre-teens should get 9-10 hours.

Return to top

Save a Life: Know the Signs of Stroke
By Lucian Maidan, MD, Director of Dignity Health Stroke Centers

Every year, nearly 800,000 Americans experience stroke. While some stroke patients die, others will live but their lives will be forever changed by the loss of brain function that often follows stroke. The good news, though, is that for many people, strokes can be prevented. And if someone does experience stroke, the quick action of those around him or her can help preserve brain function. You can help by knowing the risk factors and symptoms associated with stroke.

Risk Factors

Most strokes occur when arteries are blocked or clogged by blood clots or by the gradual build-up of plaque and other fatty deposits. This kind of stroke is called an ischemic stroke and accounts for 85% of all strokes. The other 15% of strokes happen when a weak spot on a blood vessel wall breaks, causing the artery to rupture. This type is called hemorrhagic.

Some risk factors for stroke are beyond our control, such as being over age 55, being a male, being African American, Pacific Islander or Hispanic, having diabetes and having a family history of stroke. If you or someone you love has one or more of these risk factors, it is even more important to make lifestyle changes that may reduce your risk and also to know the signs and symptoms of stroke.

  • If you smoke - quit!
  • If you are overweight - change your diet to decrease salt and fat, and begin an exercise routine of at least 30 minutes daily
  • If you drink alcohol - limit your intake to one or two drinks a week
  • Monitor your blood pressure and cholesterol levels and keep them within the healthy range


Few Americans really know what a stroke looks like and how to recognize when someone is experiencing one. Learn the symptoms and act quickly by calling 911 if you believe someone is having a stroke.

Common symptoms can include:

  • Sudden numbness or weakness of the face, arm or leg - especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

Stroke treatment is time dependent - meaning the sooner it is given the more effective it will be. Your quick reaction could save valuable brain function. Time is brain!

Return to top

Perimenopause: What to Expect
By Dana R. Jacques, MD

Menopause is something that all women are aware of and probably think about occasionally... And yet, when the first signs of it arrive, many of us don't even recognize it. Perimenopause - also called menopausal transition - is the period in a woman's life when her body shifts from regular cycles of ovulation and menstruation toward permanent infertility (menopause).

Women start perimenopause at varying ages, often in your 40s but sometimes as early as in your 30s. During this time, your ovaries are less able to regulate estrogen and progesterone levels. This change causes your hormone levels to fluctuate, dipping and sometimes rising even higher than they were before. Every woman's body responds to these fluctuations differently. Some women notice subtle symptoms, some are more pronounced, and others never experience any symptoms at all.

Among the symptoms you may experience during this transitional time:

  • Changes in your period: Your period may become irregular - longer, shorter, heavier or lighter. Your cycle may last longer than 28 days or it may be become shorter.
  • About 70% of women will have lighter, less frequent menstrual cycles, and then stop; 15% of women will have normal cycles, and then stop; 15% of women will have heavier periods, longer periods, and bleeding in between periods - and 30% of those women will have something that needs to be treated. Therefore, it is very important to log your menstrual cycles and report any unusual patterns or changes to your doctor.
  • Hot flashes: Occasionally, you may notice a hot flash or a night sweat. These bouts may come out of the blue and not reappear for some time.
  • Vaginal symptoms: You may notice vaginal dryness as your estrogen and progesterone decline.
  • Sleep disruption: Often one of the first signs a woman may notice (but not attribute to perimenopause) is sleep problems. You may have trouble falling asleep, staying asleep, or you may wake with night sweats.
  • Mood changes: You may experience unexplained sadness or irritability. This can feel a lot like typical PMS mood swings, but may occur at a time that does not coincide with your usual time of the month.

Perimenopause ends when you have gone 12 months without a period - which means you have officially reached menopause.

Unfortunately, these symptoms are sometimes associated with illnesses unrelated to perimenopause and there is really no easy way for you to determine what the true cause is. If your symptoms are bothersome, talk to your physician about them. If not, simply mention it at your annual exam.

If you are in need of Obstetrician/Gynecologist, you can reach Dr. Jacques at Roseville Obstetrics & Gynecology, 916.788.2000.

Return to top