News Archive (2009)

A Will to Serve.

By: Wanda Robert

In 2007, a meeting between doctor and patient proved to be the first step on a journey of transformation. 

The CORE Institute's Jason J. Scalise, MD is proud to have played a part in the future of one of our nation's heroes. The patient, Anthony (Toni) Brewer sat with us to share his inspiring story of determination.


Becoming a Marine is a transformation that cannot be undone."  (www.marines.com)  

Anthony (Toni) Brewer is a young man who understands the importance of hard work and reaching out to his community.  Growing up in Paradise Valley, Arizona, Brewer followed in the footsteps of his father, an officer with the Phoenix Police Department.  He began volunteering with the department at the age of 12.  It seemed obvious to everyone that after his graduation from Phoenix Christian High School he would enter a career in public safety.  The surprise came when rather than becoming a police officer; Brewer decided that he wanted to become a United States Marine.  

As a football and basketball player in high school, the athletic Brewer prepared to pass the medical evaluation portion of the Marine's processing.  It was through this medical evaluation, however, that his past shoulder injuries were brought to the forefront once again.  By speaking with Toni, the medical examiner discovered that for the past five years, his left shoulder would occasionally dislocate.  Following the evaluation at the Marine Entrance Processing Station, medical staff suggested that Brewer join a branch of the military that was not as "physically demanding" as the Marine Corps.  The Marines dismissed Toni and stopped him from enlisting, stating medical reasons. Undeterred, Brewer was not ready to give up on his dream.  The Marines understood his determination to join this elite group of men and women who serve the United States. Toni added, "The Marines said if I really wanted to pursue a career in the military, I needed to have surgery on my shoulder." 

Enter Jason J. Scalise, MD, an orthopedic surgeon with The Center for Orthopedic Research and Education in Phoenix, Arizona.  Dr. Scalise specializes in shoulder injuries and complex shoulder issues, having trained and worked at the renowned Cleveland Clinic before joining The CORE Institute.  Dr. Scalise evaluated Brewer in November 2007 for his chronic shoulder instability.  After a physical exam and MRI, Brewer was diagnosed with recurrent shoulder instability and a Bankart lesion.  A Bankart lesion is a tear of the labrum the lining of the socket of the shoulder.  This occurs when the shoulder is dislocated and can cause instability, pain, acatching sensation and an increased likelihood of future dislocations.   

Dr. Scalise noted that this "recurrent instability will prohibit" the high level of activity Brewer would need to maintain as a Marine.  After considering many possible treatments and the possible risks of surgery, for Brewer the solution was obvious -- the arthroscopic Bankart repair procedure. He wanted his shoulder fixed and believed that Dr. Scalise was the surgeon to do it. 

At Paradise Valley Hospital on December 17, 2007, Dr. Scalise performed an arthroscopic Bankart repair on Brewer's left shoulder.  The procedure took one hour and included an evaluation of his shoulder through the arthroscopic camera.  Through the small incisions, both camera and instruments were able to repair the torn labrum back to its anatomic location on the front edge of the shoulder socket and thereby restoring stability to Brewer's shoulder.  

"Mr. Brewer's surgery went extremely well.  He had a classic tear of the labrum which the arthroscopic camera showed well.  We were able to obtain a very robust labral repair.  It is interesting that a seemingly small disruption in the normal anatomy can have such profound consequences on an individual's shoulder function; and in this case, his aspirations."  After Dr. Scalise did his part repairing the tear and customizing Brewer's rehabilitation program, the job fell to Brewer to do the hard work of recovery.  A large part of this process involved physical therapy to help improve the shoulder's range of motion, improve strength and restore function.  Six weeks after surgery, Brewer began his physical therapy regimen.  Before the procedure, Dr. Scalise explained that recovery could take as long as six to seven months and there was always a chance that the shoulder may not heal properly, preventing complete recovery and function.  However, with the same energy and commitment he uses to face all challenges, Brewer tackled his rehabilitation head on – completing his rehab in ¾ the time prescribed by Dr. Scalise.  While admitting that recovery was one of the "hardest times in my life", Brewer was able to pass his physical and join the Marines on schedule. 

On June 6, 2008 Brewer graduated from boot camp at M.C.R.D. Camp Pendelton, San Diego, as his platoon's second squad leader.  This earned him a meritorious promotion to private first class.  Shortly after his graduation, PFC Brewer paid a visit The CORE Institute.  Dr. Scalise told Brewer, "Good to hear your shoulder has kept up with the rest of you." 

From the successful completion of boot camp, Brewer's next step was Iwakuni, Japan on a two year tour.  He keeps in touch with Dr. Scalise via email and during a recent trip state-side to get married, Brewer summed up his experience by saying "I had a major obstacle to overcome so I could pursue my dream of being a Marine. I can't thank Dr. Scalise enough for his efforts. He has changed the course of my career, and more importantly, my life".

Knee needs rise with aging population.

Joy Slagowski
Daily News-Sun

An aging population is causing "an explosive growth" in knee replacement surgery, according to one local expert. John Thompson, an orthopedic surgeon, will be giving a free community lecture "Joint Replacement: How do you know when it's time?" at 9 a.m. on Friday, Sept. 11 in Memorial Hall at Banner Boswell, 13180 N. 103rd Drive, Sun City.

Reservations are encouraged by calling 602-230-CARE (602-230-2273). Light refreshments will be served.

Thompson is medical director of Banner Boswell's Joint Club, a special unit dedicated to the care of patients undergoing total knee or hip replacements. Thompson specializes in adult reconstruction, and primary and revision hip and knee replacement surgery.

"They should try all of the non-operative means first, such as over-the-counter remedies, topical ointments, Tylenol, and non-steroidal anti-inflammatory meidations." Thompson said. "(They should also try) ice, heat, bracing and activity modifications. They should also try physical therapy, injections and also herbal medications."

But if those fail, surgery can be a consideration if radiographs confirm degenerative arthritis.

The surgery is extremely painful, Thompson said, and recovery takes a full year.

"The first 48 hours are when there is the most significant amount of pain," Thompson said. "But we begin physical therapy about three hours after surgery, which at that point is when we get everyone up and walking."

A normal hospital stay is three days, with physical therapy taking place twice a day while there.

Thompson said about 50 percent of patients recover within about two months, while it will take three months for another 25 percent to recover.

"It takes a year to be 100 percent recovered," Thompson said. "Also, we tell patients if they have both knees replaced at the same time, they never heal at the same rate: one hurts and is more stiff than the other."

In the long run, though, studies are showing those who have knee replacements are actually saving money.

"When they start calculating the pain medication, disability from it, or time off work, it's one of the few procedures that confirms its cost effectiveness is great," Thompson said.

Doctor Stresses Need for Seniors to Exercise.

A local sports medicine physician will discuss the need for seniors to reverse a trend of "underuse" of muscles by becoming active again, as well as rehabilitative activities for common injuries Wednesday at the Sun City West Foundation.

Dr. John Kearney, a specialist in non-operative, rehabilitative and medical aspects of sports medicine, will present his expertise about the importance of staying active in general, the benefits of different types of exercise and the best ways to prevent over-use injuries.

"Staying active should be a priority in everyone's life," said the physician, who works with the Center for Orthopedic Research and Education based in Sun City West. "Everybody should be aiming for at least two hours a week of activity that gets you out of breath and makes you sweat."

Seniors should look for an activity they enjoy, whether it's bocce or lawn bowling, as long as they stick with it, Kearney said.

"Whatever (seniors) enjoy and they can participate in, that's the most important thing," he said. "The goal should be to find something you enjoy doing that you can stick with."

Often, seniors face injuries during physical activity, and they become discouraged about continuing to exercise. Kearney said the correct rehabilitative techniques can often ease the pain.

"There are usually very simple things (seniors) can do to stack the odds in (their) favor to treat an injury or prevent an injury from occuring," he said. "In general, with seniors we see a lot of shoulder, knee and back problems. Chronic underuse is just a natural, slow decline in the muscles that support the joints. We can usually get those feeling a lot better with the right physical therapy and strengthening.

"(It's common for seniors to) think that they need to exercise less whenever they run into a painful problem. They tend to give up very easily, when in reality there's usually an easy way to fix the problem."

The presentation, sponsored by the Foundation, Recreation Centers and Property Owners and Residents Association of Sun City West, will be at 1:30 p.m. Wednesday at the Sun City West Foundation Building, 14465 R.H. Johnson Blvd.

The talk is open to the public. 

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