Dumaguete Online Pain Care Center & Orthopedic Clinic

24/06/2025

⚠️ Achilles Tendon Tear – A Serious but Treatable Injury

The Achilles tendon is the thick, fibrous band connecting your calf muscles to your heel bone. It’s crucial for walking, jumping, and pushing off during movement.

🦶 What happens during a tear?
An Achilles tear often feels like a sudden “snap” or being kicked in the back of the ankle — even when no one is around. It can happen during explosive movement or from pre-existing strain.

📌 Recent example:
NBA star Tyrese Haliburton suffered a complete Achilles tear during Game 7 of the NBA Finals — with no contact, just a sudden collapse after pushing off. He had been playing through a calf injury, which likely increased the risk.

🔍 Common Signs:
• Sudden sharp pain at the back of the ankle
• A popping sound or feeling
• Difficulty walking, especially pushing off
• Swelling or bruising above the heel

⚙️ Treatment Options:
• Surgical repair for complete ruptures or active individuals
• Conservative treatment (brace + rehab) for partial tears or lower activity levels
Recovery takes 6 to 12 months, but return to full function is possible with proper care.

👉 Don’t ignore sudden ankle pain, especially after sports or activity. The earlier it’s treated, the better the outcome.

23/06/2025

First Megaprosthesis Surgery for Bone Cancer Performed at Silliman University Medical Center

Dumaguete City, Philippines – June 13, 2025

Silliman University Medical Center (SUMC) has reached a new milestone in orthopedic care with the successful completion of its first-ever proximal femoral megaprosthesis surgery, performed last Friday, June 13, 2025. The operation marks a significant advancement in the hospital’s capacity to offer specialized musculoskeletal oncology and joint reconstruction services.

The patient, a 55-year-old woman with a history of breast cancer, presented with a severely weakened left proximal femur (upper thigh bone) due to metastatic disease. She suffered from a pathologic fracture near the hip, requiring urgent intervention to relieve pain, restore mobility, and prevent further complications.

During the operation, the surgical team removed the damaged portion of the femur and replaced it with a custom modular implant known as a “megaprosthesis.” This advanced prosthetic device provides structural support, improves limb function, and allows for early weight-bearing postoperatively.

The procedure was led by Dr. Alfred J. Miralles, MD, DPBO, FPOA, an orthopedic surgeon specializing in arthritis and joint replacement surgery, Dr. Miralles completed his orthopedic training at East Avenue Medical Center and is a proud fellow of the late Dr. Ramon B. Gustilo, a global leader in hip and knee replacement.

“This surgery was about more than replacing bone—it was about restoring quality of life,” said Dr. Miralles. “I’m proud to have led this pioneering case at SUMC and thankful to the entire surgical and nursing team for making it possible.”

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🔧 What Is a Megaprosthesis?

A megaprosthesis is a specialized, large-scale implant used to replace massive sections of bone, often in cases of tumor, trauma, or metastatic disease. It is designed to allow immediate limb function and prevent limb loss when standard joint replacement is not enough.

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This breakthrough case demonstrates SUMC’s growing capability to handle complex orthopedic oncology and reflects the institution’s ongoing mission to bring expert, high-quality, and innovative care closer to the people of Negros Oriental and beyond.

20/06/2025

We make surgeries and recovery look easy…we make it look easy!

WHY SOME DOCTORS BILL MORE THAN OTHERS

Title: “Just Five Minutes?”

Mila stormed out of the clinic, clutching the white prescription paper in her hand and shaking her head in disbelief. “Five minutes. I paid ₱800 for five minutes,” she muttered, eyes wide with exasperation.

She sat on the nearest bench and began venting to her husband over the phone.
“Alam mo, he just asked me three questions — ‘Saan masakit? Kailan nagsimula? May lagnat ka ba?’ Then he listened to my back, looked at my throat, and wrote this! That was it. I didn’t even get to finish explaining everything I googled!”

On the other end of the line, her husband tried to calm her down. “Baka naman magaling ‘yung doctor?”

“Magaling? E ni hindi ako tinanong tungkol sa diet ko o lifestyle,” Mila snapped. “I could’ve done that myself.”

What Mila didn’t see — and what many never do — was the unseen work behind that “five-minute” consult.

The doctor had reviewed her chart the night before, recognizing her name from previous visits. His years of internal medicine practice told him which symptoms pointed to something serious and which ones didn’t. He noticed her breathing pattern as she walked in, the slight hoarseness in her voice, the subtle wince when she shifted in her seat.

He asked the right questions, examined the right places, and gave the right treatment — not because he was rushing, but because he had trained for decades to be that precise.

What took him five minutes took him twenty years to master.

And that’s what many patients don’t understand: you're not just paying for time — you're paying for expertise.

That’s also why some doctors bill more than others. It’s not just the title "doctor" that sets the fee, but how much they’ve invested in their training, their subspecialty, their experience, and the accuracy and safety they can offer in return. A more experienced doctor can often make the right call faster, with fewer tests and fewer errors — and that kind of efficiency isn’t cheap.

Mila’s ₱800 paid for more than five minutes. It paid for the confidence that she didn’t need an unnecessary lab, or a wrong medicine, or a week of worrying. It paid for a quick diagnosis made with precision — the kind only possible through long years of study, failures, learning, and patient care.

Sometimes, the best doctors make it look easy.

That’s the cost — and the value — of true medical expertise.

18/06/2025

16/06/2025

A 55-year-old woman with a history of breast cancer who had developed a severe fracture in her upper thigh bone due to bone weakening from metastasis underwent a very difficult procedure.

We replaced the damaged bone with a custom metal implant called a megaprosthesis, designed to restore strength, improve mobility, and reduce the risk of future injury.

It’s a life-changing procedure for patients in this condition—one that offers a real chance at standing, walking, and living with less pain immediately within few days after surgery.

As a surgeon, I’m grateful to be in a position where I can bring advanced reconstructive solutions closer to those who need them. Moments like this remind me that healing is not just about fixing what’s broken, but about giving people back their movement and independence.

09/06/2025

Common cause of back pain

Sitting Posture and Health

Sitting posture has a big impact on physical health, productivity and well-being especially with prolonged sitting common in modern life. Poor posture can lead to pain and long term issues, while good posture has benefits, according to Journal of Physical Therapy Science (2021) and NIH.

Poor Posture: Slouching or hunching strains the spine, increases lower back pain by 25%, according to Spine Journal (2020). Forward head posture stresses neck muscles, causes discomfort in 30% of office workers, according to Springer Nature. It reduces lung capacity by 10%, limits oxygen flow, according to Journal of Applied Physiology. Poor posture also compresses abdominal organs, slows down digestion by 15%, according to American Journal of Gastroenterology (2019) and causes fatigue and reduced focus.

Good Posture: Sitting up straight with shoulders relaxed, back supported and feet flat aligns the spine, reduces back pain by 20%, according to Journal of Orthopaedic Research. It improves circulation, boosts energy by 12%, according to NIH. Good posture improves breathing efficiency, increases oxygen to the brain for 10% better cognitive performance, according to Journal of Neuroscience. It also supports healthy digestion, reduces bloating, according to Nutrients (2020).

How to Improve Sitting Posture:

Ergonomic Setup: Adjust chair height so knees are at 90°, backrest supports the lower back. Monitors at eye level, 20-30 inches away, according to Occupational Health Journal.

Take Breaks: Stand and stretch every 30 minutes for 1-2 minutes to reduce muscle tension by 15%, according to Journal of Sports Science.

Strengthen Core: Practice yoga poses like Cat-Cow to strengthen spinal stability, according to Yoga Journal.

Mindful Sitting: Check posture hourly, ears should align with shoulders and hips.

Tips: Pair with a nutrient rich diet (25g fiber/day, e.g., spinach) and 2-3L water to support muscle health, according to USDA. Use a lumbar roll or ergonomic chair for extra support. Practice 10-min daily mindfulness to reduce stress which worsens posture, according to Psychoneuroendocrinology. Standing desks can reduce sitting time by 20%, according to American Journal of Preventive Medicine.Tips: See a doctor if pain persists, it may be a spinal issue, according to NIH. Don’t overcorrect posture which strains muscles in 5% of cases, according to Journal of Clinical Orthopaedics. If new to exercise start slow to avoid injury. Make sure ergonomic setup fits your body.

Good sitting posture is natural comfort, health and productivity.

30/05/2025

25/05/2025