Jennie Keel is passionateabout CrossFit – the stren-uous strength and conditioning program that mixes

weightlifting, gymnastics andcardio exercises. It’s not onlyher favorite sport; it’s also herdream job.But four years ago, she tore

her labrum in both shoulderswhile demonstrating anOlympic weightlifting maneuver called a split jerk.She knew right away she was hurt.Keel saw Dr. Adam Smith at West Ten-

nessee Bone & Joint Clinic. He confirmed theinjuries with an MRI and helped her decidewhat to do next. “He told me to tolerate it aslong as you want and come back and see mewhen you can’t tolerate it anymore,” Keel said.With the help of physical therapy a couple

times a year at West Tennessee Bone & Joint,Keel worked through the pain as it grew in-creasingly worse over time. By November2012, it was unbearable.“I couldn’t drive my car,” Keel said. “I

couldn’t hold my steering wheel.” She could nolonger participate in CrossFit, and she couldn’tshare her love for the sport with her clients.She owns CrossFit Jackson with her hus-

band, Jayson, and their business has grownfrom a group of friends exercising in a park to anew building on Executive Drive. They have165 clients from kids to adults who rely onthem as fitness instructors. “I was personally devastated,” she said. “My

sport, my passion and my profession where af-fected, so it was time to get it fixed.”Dr. Smith performed surgery on her left

shoulder in November and on her right shoul-der in February. He told her to expect recoveryto take at least six months.

Today, she said her shoulders are back to 90 per-cent, and she expects to fully recover – particularlybecause she closely follows the advice of Dr. Smithand the clinic’s physical therapists. “I did everythingthey told me to do,” Keel said.She’s CrossFit training again, and she’s coaching

her clients. She said she’s very appreciative of Dr.Smith and the West Tennessee Bone & Joint staff forhelping her return to her favorite sport. “They’re great; I love them. They care about what

you care about. They take into consideration whatyour goals are, and they work with you.”

Keeping you...

ActiveActive

Keeping you...Active Active … is a quarterly

newsletter fromWest TennesseeBone & Joint Clinic. The clinic’s 11 physicians specializein sports medicine,hand injuries anddisorders, and or-thopedic diseasesand musculoskeletalinjuries. For copiesof this newsletter,contact Adam Kelley, MarketingDirector, at731.661.9825.

Like us on Facebook!

Shoulder surgery allowed athlete toreturn to strenuous CrossFit training

Jennie Keel uses her CrossFit training in a competition.

731.661.9825 n 888.661.9825 n www.wtbjc.com

Summer 2013 Sports Medicine • Orthopedic Excellence

Jennie Keel

Read more …n Physician pioneers

wide-awake handsurgery

n Preventing heat-related illness

n www.wtbjc.com:New look, new features

n Patient with osteoarthritispraises her physian

Wide-Awake SurgeryHand surgeon pioneers carpal tunnel surgery

with numbing medicine rather than general anesthesia

Dr. Michael Dolan at West Tennessee Bone & Joint Clinic ispioneering a new kind of hand surgery that many in themedical community thought was impossible five years ago.

Instead of general anesthesia, Dr. Dolan injects a mixture of lido-caine and epinephrine into the wrist of patients to numb the area forsurgery. Although dentists commonly use the injection, medical stu-dents were taught for decades not to inject epinephrine – or adrena-line – into the hand, Dr.Dolan said.“It’s something totally

new,” said Dr. Dolan, who isboard certified in both gen-eral surgery and hand surgery. Epinephrine constricts

blood vessels, which allowsthe localized numbing effectsof lidocaine to last longer, butthe medical communityfeared for a long time that itwould restrict blood flow tothe extent of killing the hand.That has been proven wrong,Dr. Dolan said, and wide-awake hand surgery is a re-markably easier experiencefor patients.

Patients do not have to abstain from eatingor drinking. They keep their street clothes onand receive a single shot in the wrist, which isless painful than the IV required for generalanesthesia. They then sit painlessly throughthe procedure while Dr. Dolancarries on a conversation withthem, he said.“Then they stand up, walk

out and go home.” It is not uncommon for pa-

tients to spend a night – ormore – recovering in the hospital after general anes-thesia. The required prep work also can require themto arrive at the surgery center hours in advance.

General anesthesia is also a vascular stressor, Dr. Dolan said, and pa-tients often feel as if they have just run a race. With wide-awake surgery,the numbness of the lidocaine wears off after about six hours.Patients are injected with Marcaine after the procedure, which

prevents them from experiencing pain for another 24 hours. By thattime, the pain is gentle enough that it can be treated with ibuprofen.Some patients have had the wide-awake procedure on their lunch

break and returned to workfor the rest of the day, Dr.Dolan said. And, because therecovery period is lesspainful, patients often don’tneed the regimen ofpainkillers that can becomeaddictive and that are associ-ated with the aftermath oftraditional surgery, he added.“Many people go through

the wide-awake surgery with-out a single narcotic.”General anesthesia also

carries the risk of complica-tions that could be fatal. As aresult, wide-awake surgery issafer. It’s also cheaper for pa-

tients and faster for doctors to perform, he said.“It allows us to get patients in and out of the operating theater

much quicker.”Dr. Dolan has performed wide-awake surgery on patients from

ages 12 to 95, though, typically on patients with carpal tunnel syn-drome or trigger finger. He also uses the procedure to remove a be-

nign cyst or to repair a hand after a laceration orother trauma.In 2010, the first year he performed the tech-

nique, 10 percent of his carpal tunnel surgeries werewide-awake. The number grew to 30 percent in2011 and 50 percent in 2012. This year, 75 percentof his carpal tunnel surgeries have been done withthe patient wide awake.“We’ve all just been wowed about it because the

patients just do so well,” Dr. Dolan said.

West Tennessee Bone & Joint Clinic holds drawings to award gift baskets to those who have filled out our online patient satisfaction survey. Read what one patient has to say, back page. To fill out the survey, visit wtbjc.com.

This year, about 75 percent of Dr. Michael Dolan’s carpal tunnel patients were wideawake as he performed surgery on their hand.

Some patients havehad the wide-awakeprocedure on theirlunch break and returned to work forthe rest of the day.

Michael Dolan, M.D.

Summer’s heat and humidity are officiallyhere. According to the national Centers forDisease Control, more than 300 Americans die

every year from heat-related illnesses. When exposed to excessive heat, the body can be unable

to properly cool itself, leading to dangerously high body tem-peratures and medical conditions, such as heat exhaustion and heatstroke. Let’s take a quick look at some helpful facts to help you avoid aheat-related illness …

n Elderly people (65 and older), infants and children and people withchronic medical conditions are the most vulnerable to heat stress.

n Air conditioning is the best protection from heat. During peak sunhours, try to stay indoors. If your home is not air conditioned, visitpublic facilities such as shopping malls, libraries or movie theaters tostay cool.

n If you must be outside, drink plenty of water to stay hydrated, seekout shady areas, and take frequent rest breaks from your activity.

n Avoid coffee, alcohol and tea, which contribute to dehydration.nWear a hat and loose, light-colored clothing to dissipate heat.n Recognize the signs of heat stroke: high body temperature, rapid pulse,difficulty breathing, the absence of sweating with hot red and flushedskin, hallucinations, confusion and disorientation.

Written by Jesse Gatlin, Physical Therapist

Let’s get a physical!

About 600 to 700 high school student athletes walked through the doors of West Tennessee Bone & JointClinic in May to get a physical. TSSAA requires an annual physical before an athlete can play a sport.

Bone & Joint physicians did physicals for students at North Side, South Side, Madison and South GibsonCounty high schools, University School of Jackson, Jackson Christian School and Trinity Christian Academy.

Preventing heat-related illness

Website offers new look,videos, easy navigation

Besides a complete redesign, the biggestchange to our website is the addition of an

interactive section on orthopedic injuries. Weexplain how the joint works and what willhappen in surgery through pictures and video.You also can request prescription refills, ask

insurance and billing questions, fill out patientforms online and tell us what you think withour online patient-satisfaction survey. You’llfind past newsletters and stories, too. You’ll appreciate the patient-friendly navi-

gation on our site. Visit us at www.wtbjc.com.

Lowell Stonecipher, M.D.

Michael Cobb, M.D.

David Johnson, M.D.

KellyPucek, M.D.

HaroldAntwine III, M.D.

DavidPearce, M.D.

JasonHutchison, M.D.

AdamSmith, M.D.

J. DouglasHaltom, M.D.

JohnEverett, M.D.

MichaelDolan, M.D.

Donna Klutts, CMPEPractice Administrator

Keeping You ActiveThe physicians at West Tennessee Bone & Joint

Clinic, P.C. specialize in comprehensive

orthopedic care for adults and children. This

includes sports medicine, hand injuries and dis-

orders, orthopedic diseases and musculoskeletal

injuries. Our physicians are Board Certified.

They see patients in …Jackson • Brownsville • Selmer Lexington • Parsons • Dyersburg

Union City • Bolivar • Ripley

24 Physicians Drive, Jackson n 731.661.9825 n 888.661.9825 n www.wtbjc.com

Despite severe osteoarthritis, patientstays active with help from WestTennessee Bone & Joint Clinic

Vicki Johnson, associate vice presidentfor academics at Freed-Hardeman

University, is very familiar with West Ten-nessee Bone & Joint Clinic and its staff.She’s battling osteoarthritis in just

about every joint from everyday wear andtear, she said. She also has had a series ofmajor surgeries. And through them all,Dr. Kelly Pucek has been there to help hernavigate her options and make the bestdecisions about her joints.“I have a tremendous amount of confi-

dence in him,” Johnson said. “He’s a verycaring doctor. He will listen to you andanswer your questions.”In 2005, Johnson had both knees re-

placed, which greatly reduced her painafter she recovered from the procedure. “The knee replacement is the best

thing I’ve done,” Johnson said.

In 2009, she had surgery torepair a tendon in her foot. Andin 2012, she went in for shoul-der surgery.Johnson said an MRI of her

shoulder showed bone spurs,but during the procedure to re-move them, Dr. Pucek discov-ered and repaired a shreddedtendon in her bicep and a partial rotator-cuff tear. “The pain is much more bearablethan it was before the surgery.”She said that, in addition to annual

visits for knee X-rays, Dr. Pucek is keepingan eye on her shoulder to monitor itsprogress. She may need another proce-dure. She also may need hip surgery, shesaid.Although she’s been through multiple

surgeries, and she may have to endure

more, Johnson said Dr. Pucek doesn’t rushinto doing surgery. Instead, he looks forother ways to manage her pain until it’stoo much to bear and surgery becomes thebest option.“He is an excellent doctor, and the

nurses are very kind,” Johnson said. Sheadded that her experience has been greatat West Tennessee Bone & Joint, and shehas referred two or three of her friends tothe clinic as a result.

Dr. Kelly Pucek and patient Vicki Johnson