Personalized Orthopedics of the Palm Beaches

05/06/2024

Our hands are essential for nearly everything we do, but we often take their health for granted until pain or injury strikes.

Recognizing and treating common hand conditions is important for maintaining our daily routines and overall well-being. This article explores the vital role of orthopedic care in diagnosing and managing these issues effectively.

IDENTIFYING COMMON HAND CONDITIONS
Orthopedic surgeons treat various hand conditions, such as carpal tunnel syndrome, arthritis, trigger fingers, and fractures. Early diagnosis is vital for effective treatment.

Here are some of the common hand conditions an orthopedic surgeon could help diagnose and treat:

1. CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome happens when one of the primary nerves in the hand is squeezed as it passes through the wrist. The condition causes:

Numbness
Tingling
Weakness in the hand
When you see a hand doctor, they will diagnose carpal tunnel syndrome by taking your performing patient history, physical examination, and sometimes diagnostic tests.

Then, nerve conduction studies can confirm the diagnosis by measuring the speed of electrical impulses through the median nerve in the wrist.

In some cases, ultrasound or MRI help visualize and identify any anomalies.

TREATMENT OPTIONS
Non-surgical treatments include wrist splinting, medication, physical therapy, and corticosteroid injections. Surgical options may be considered for severe cases, such as carpal tunnel release surgery.

2. ARTHRITIS IN HANDS
Arthritis affects the joints in the hand and fingers, causing pain and stiffness. Osteoarthritis and rheumatoid arthritis are common types, with symptoms including joint pain, swelling, and reduced mobility.

To diagnose hand arthritis, your hand doctor will take a detailed medical history and perform a physical examination. The doctor will ask about symptoms and any history of injury to the hand joints.

Your doctor will also conduct range of motion tests, while radiographic tests, such as X-rays, are commonly used to visualize the extent of joint damage. In some cases, blood tests may help identify specific types of arthritis.

TREATMENT APPROACHES
Treatment includes medication, physical therapy, and corticosteroid injections. The goal is to manage pain and improve hand function.

For severe cases, surgical options such as joint fusion, joint replacement, or osteotomy may be considered to restore function or relieve pain.

3. TRIGGER FINGER
Trigger finger causes pain, stiffness, and a locking sensation in the finger when a tendon sheath becomes inflamed.

To diagnose trigger finger, your doctor will look for a tender nodule in the palm, right at the base of the affected finger or thumb. They may also assess the finger’s range of motion and look for any signs of locking or catching. In uncertain cases, ultrasound imaging might be used.

TREATMENT PLANS
Treatment options include splinting, medication, and injections. Physical therapy and gentle stretching exercises can also help.

In some cases, surgery may be necessary. This involves cutting the affected section of the tendon sheath to allow the tendon to move freely again.

4. HAND FRACTURES
Hand fractures, or breaks in the bones of your hand, can result from falls, sports injuries, or direct blows. Diagnosis starts with a thorough medical history and physical examination.

The healthcare provider will ask about:

How the injury occurred
The location of the pain
If there was any previous injury to the hand
They will look for signs of swelling, tenderness, deformity, and bruising. They will also assess the range of motion and the functionality of the fingers and hand.

Imaging tests, such as X-rays, are the primary method used to confirm a fracture. In more complex cases, CT scans or MRIs may be utilized.

TREATMENT OPTIONS
Treatment may involve immobilizations with casts or splints. casting, splinting, or surgery. Pain relief medication and ice can also help manage pain and swelling.

Additionally, physical therapy can aid in restoring range of motion, strength, and functionality to the hand.

In the case of complex fractures, surgery may help realign and stabilize the bones.

PREVENTING COMMON HAND CONDITIONS
Here are practical tips to help keep your hands and wrists healthy:

Perform exercises to strengthen hand muscles and improve flexibility.
Set up your workspace to support wrist and hand health.
Use protective equipment during activities that put your hands at risk.
Eat a balanced diet rich in anti-inflammatory foods.
Stay hydrated and maintain a healthy weight.
Take regular breaks during work to relax your hand.
Remember, early intervention is key to managing hand conditions effectively.

If you experience persistent pain or discomfort in your hands, seek advice from a healthcare professional.

03/25/2024

Tendons are made of collagen, a protein that gives them both strength and flexibility. This combination allows tendons to withstand tension while helping the body to move. They are not only located in your arms and legs; tendons are everywhere, from your neck to your toes, playing a part in every motion.

Some tendons are more prone to problems than others. The Achilles tendon, connecting your calf muscle to your heel, is a common trouble spot. The rotator cuff tendons in the shoulder and the tendons around the wrists and elbows are also prone to injury. These areas often face injuries due to overuse or repetitive motion, making them key areas to watch for tendon problems.

TENDONITIS VS. TENDINOSIS
Tendonitis and tendinosis are two distinct conditions affecting the tendons, often confused due to their similar names but differing significantly in their nature and treatment.

WHAT IS TENDONITIS?
Tendonitis is an inflammation of the tendon, typically resulting from overuse or injury. Key aspects include:

Causes: Repetitive motion, sudden injuries, or age-related wear and tear.
Symptoms: Sharp pain at the tendon site, swelling, tenderness, and pain with movement.
WHAT IS TENDINOSIS?
Tendinosis is a chronic condition caused by tendon degeneration over time. The primary difference between tendinosis and tendonitis is that it is degenerative rather than inflammatory.

Causes: Long-term overuse and age-related changes.
Symptoms: Gradual pain development, lasting discomfort, tenderness.

02/13/2024

HOT OFF THE PRESS! See the article authored by our own Dr. Gregory Martin published in ythe Journal of Orthopaedic Experience and Innovation..https://journaloei.scholasticahq.com/api/v1/articles/91633-in-my-experience-personalized-hip-and-knee-arthroplasty.pdf

01/19/2024

There are many orthopedic conditions that can affect the knee, leading to pain and limitations. However, the human body is resilient. With the right treatment and guidance, you can return to a healthy and active lifestyle and keep getting stronger.

Physical therapy is a crucial part of rehabilitation that taps into your body’s natural healing ability. Learn more about the importance of physical therapy and how it can help your knees recover and even become stronger than before.

KNEE REHABILITATION IN SPORTS MEDICINE
The knee is a complex and vital joint for movement. Unfortunately, it’s susceptible to injury, particularly for athletics. As part of the recovery process, knee rehabilitation is a comprehensive approach to healing and strengthening your injured knee. It involves several stages that slowly progress towards regaining optimum knee function.

THE PROCESS OF KNEE REHABILITATION
Knee rehabilitation within sports medicine can be a slow but extensive process. It begins with an assessment and accurate diagnosis by your doctor. This can help your healthcare team work together to create a tailored recovery plan for your personal situation.

Your rehabilitation journey may involve multiple stages. These stages include:

Pain and swelling management
Knee mobility recovery
Strengthening and conditioning
Functional training
Additionally, a significant, yet often overlooked aspect of knee rehabilitation, is educating patients. Understanding the mechanics of knee movement, the dos and don’ts during recovery, and strategies to prevent future injuries is just as important as the physical exercises.

It’s also not just about the physical. Knee rehabilitation is a mental and emotional journey, as well. The support and guidance of a healthcare team are pivotal in navigating the ups and downs of this journey.

THE IMPORTANCE OF PHYSICAL THERAPY IN KNEE REHABILITATION
A cornerstone of knee rehabilitation is physical therapy. It goes beyond simple exercise – it’s about retraining the body and mind to work in harmony. Physical therapy addresses pain management, restores range of motion, and gradually rebuilds strength. It’s about learning how to use your knee again, so you can function better than before.

HOW PHYSICAL THERAPY WORKS
Physical therapy aims to help manage pain, improve range of motion, strengthen the knee, and restore function. This recovery process can take weeks to months, depending on your condition and treatment plan. Over time, you can return to your active lifestyle.

A physical therapist will guide you through each session. Here are some effective strategies and exercises that can play a crucial role in knee rehabilitation.

Range of Motion Exercises – It’s vital to focus on maintaining and improving the range of motion of the knee joint. This can help you move more freely and without pain.
Strengthening Exercises – Strong muscles are key to supporting and stabilizing the knee joint. Initially, these exercises involve easy and gentle movements. As you progress and build your strength, you can begin doing more complex and intense exercises.
Proprioceptive Training – Proprioception refers to the body’s ability to perceive its position in space, which is crucial for balance and joint stability. Proprioceptive exercises work to improve balance.
Manual Therapy – This involves hands-on techniques performed by the therapist. Techniques may include massage, mobilization, and manipulation of the knee and surrounding structures.
Modalities for Pain and Swelling Management – Physical therapists often use modalities like ice therapy, heat therapy, and more to manage pain and reduce swelling.
Functional and Sports-Specific Training – As recovery progresses, it’s important to tailor therapy to fit the patient’s daily activities or sport. For athletes, this means incorporating drills and exercises that mimic the demands of their specific sport.

HOW TO MAKE THE MOST OF PHYSICAL THERAPY
As you begin your physical therapy journey, learn how you can effectively use these exercises and techniques to recover. Here are some practical tips that can help you maximize the benefits of physical therapy.

Set clear goals about what you hope to achieve. Communicate these goals with your therapist to help tailor a program that aligns with your needs.
Consistency is key in physical therapy when attending your sessions and performing your prescribed home exercises.
Be patient. Progress in physical therapy can be gradual. Don’t rush your recovery.
Engage actively in your sessions. Ask questions, provide feedback about what feels good or painful, and engage in the exercises with focus and dedication.
Monitor your progress and celebrate the small victories.
Take care of yourself. Make sure you get enough rest and nutrition.

11/27/2023

KNEE PAIN IN ATHLETES: PREVENTION, TREATMENT, AND RETURN TO PLAY
Knee pain can originate from various sources, and understanding the underlying causes is crucial for effective prevention and treatment. Common causes include the following:

Overuse
Physical injuries and trauma
Underlying medical conditions
Recognizing the signs and symptoms is the first step in addressing knee pain.

OVERUSE INJURIES
Overuse injuries often occur when athletes push their bodies beyond their limits, leading to stress on the knees. Runners, cyclists, and other endurance athletes are particularly susceptible to this type of injury.

PHYSICAL TRAUMA
Traumatic incidents involve sudden accidents or impacts that cause immediate pain and damage. Football players, basketball players, and skiers are at higher risk for these types of injuries.

UNDERLYING ISSUES
Underlying medical conditions that can cause knee pain often include:

Osteoarthritis
Rheumatoid arthritis
Previous injuries
SIGNS AND SYMPTOMS
Signs and symptoms of knee pain are:

Persistent discomfort
Stiffness
Swelling
Inflammation
Limited range of motion
Athletes should never ignore these warning signs, as early diagnosis and intervention can prevent further damage and complications.

PREVENTION STRATEGIES
Preventing knee pain should be a priority for all athletes. Here are some effective strategies to keep your knees healthy:

WARM-UP AND COOL-DOWN ROUTINES
Before starting any strenuous activity, it’s essential to warm up your muscles and joints. Incorporate dynamic stretches and mobility exercises into your warm-up routine. After your workout, engage in a cool-down session to help your body recover.

STRENGTH AND FLEXIBILITY TRAINING
Regular strength training exercises, focusing on the muscles around the knee joint, can provide stability and support. Similarly, flexibility exercises help maintain a full range of motion in your knees.

PROPER TECHNIQUES AND FORM
Whether you’re lifting weights, running, or playing a sport, using proper techniques and maintaining good form can reduce the strain on your knees.

ADEQUATE REST AND RECOVERY
Overtraining can increase the risk of knee injuries. Make sure to incorporate rest days into your training schedule and prioritize recovery methods such as foam rolling and stretching.

APPROPRIATE FOOTWEAR AND GEAR
Wearing the right shoes for your activity and using protective gear, such as knee braces for contact sports, can reduce the risk of knee injuries.

TREATMENT APPROACHES
If you’re experiencing knee pain, it’s crucial to seek prompt treatment. Here are some common treatment approaches for knee pain in athletes:

PHYSICAL THERAPY AND REHABILITATION
A physical therapist can design a personalized rehabilitation program that includes strengthening exercises, range of motion exercises, and proprioceptive training. These exercises can help improve knee stability and function.

MEDICATIONS AND PAIN MANAGEMENT
Over-the-counter pain relievers like ibuprofen or prescription medications can help manage pain and inflammation. It’s important to consult a healthcare professional before using any medication.

INJECTIONS
In some cases, healthcare providers may recommend injections, such as corticosteroids or hyaluronic acid, to reduce inflammation and pain.

SURGICAL INTERVENTION: KNEE REPLACEMENT
Common procedures include:

Arthroscopy
Ligament reconstruction
Meniscus repair
Knee replacement surgery
Knee replacement surgery can also be a game-changer for athletes dealing with chronic knee pain and limited mobility. This procedure involves replacing damaged joint surfaces with artificial components, restoring function, and reducing pain.

RETURN TO PLAY
One of the most challenging aspects of recovering from a knee injury for athletes is knowing when it’s safe to return to their sport. Here’s how the process typically works:

IMPORTANCE OF MEDICAL CLEARANCE
Athletes should never rush back into their sport without proper medical clearance. Consult with your healthcare provider and follow their recommendations closely.

GRADUAL AND PHASED APPROACH
Returning to sports should be a gradual process. It often involves functional testing to assess your readiness. You’ll gradually reintroduce sport-specific drills and exercises into your routine.

MONITORING PROGRESS
Throughout the return-to-play process, your progress will be closely monitored. Your healthcare provider and physical therapist will evaluate your knee’s stability, strength, and range of motion along the way.

PSYCHOLOGICAL READINESS
Don’t underestimate the psychological aspect of recovery. Fear of re-injury or hesitation can affect your performance. Work with a sports psychologist if needed to build confidence.

AVOIDING RE-INJURY
The goal is not just to return to play but to stay in play. Athletes should be cautious and proactive in avoiding situations that could lead to a recurrence of their injury.

KNEE REPLACEMENT SURGERY NEAR ME IN BOYNTON BEACH, FL
In the world of sports, knee injuries are a common and challenging obstacle. However, with a combination of prevention strategies, effective treatment approaches, and a cautious approach to returning to play, athletes can overcome knee pain and continue pursuing their passion for sports. Remember that the key to success lies in early intervention, professional guidance, and a commitment to long-term joint health and athletic success.

11/24/2023

09/18/2023

Falls are the leading cause of injury for adults ages 65 years and older. Over 14 million, or 1 in 4 older adults report falling every year. While not all falls result in an injury, about 37% of those who fall reported an injury that required medical treatment or restricted their activity for at least one day, resulting in an estimated nine million fall injuries. Falls are the leading cause of injury-related death among adults ages 65 and older, and the fall death rate is increasing. Please schedule an appt to see one of our providers as soon as possible

08/29/2023

Hip replacement revision is an orthopedic surgery to remedy a first hip replacement that failed because of problems or damages. This second procedure is more complex and takes longer because of the thorough planning required. Most cases of hip replacement surgeries are successful, but should you encounter problems, your surgeon will replace your implant. Like the first procedure, they may swap only part of the original or the entire prosthesis.

However, knowing about the procedure before undergoing hip replacement revision can help ensure that you are informed and prepared for the procedure and recovery process.

1. HOW HAVE YOU HANDLED SIMILAR CASES BEFORE?
This question will help you learn about your specialist’s experience handling hip replacement revision cases like yours. Like other surgeries, procedures are performed generally the same way but have little variations depending on the patient’s specific case.

Asking this question will reveal your specialist’s familiarity with your hip’s condition. If they have successfully handled similar cases, you can rest assured you are in good hands.

2. WHAT ARE THE RISKS INVOLVED WITH THIS PROCEDURE?
Every orthopedic surgery involves some risk, and your specialist should tell you what that is for hip replacement revision. Compared to hip replacement surgery, revision procedures are a little riskier and more complex.

Ensure to ask about the potential complications and how likely they occur.

The most common risks associated with the procedure are:

Infection
Damage to surrounding tissue
Nerve damage
Potential problems with healing
Implant loosening or dislocation
However, it is also worth remembering that the procedure will help relieve pain and restore range of motion and mobility.

3. HOW WILL MY RECOVERY PERIOD LOOK LIKE?
Recovery time and expectations vary from patient to patient. However, your specialist can estimate how long it will take for you to recover from the surgery.

They can also tell you what activities you should avoid or reduce during that time.

Additionally, your specialist will inform you about the medications you may need following the surgery. You may also expect instructions for taking care of the incision site.

4. WILL I BENEFIT FROM FOLLOW-UP CARE AFTER THE OPERATION?
Your specialist can provide information about the type of follow-up care you will need after the operation. That includes physical therapy, tests, or other treatments necessary for a full recovery.

Physical therapy is one of the most important aspects of follow-up care. It can help you regain strength and mobility in your hip.

Your surgeon may refer you to a therapist, who can then help you by doing the following:

Teaching exercises to help regain motion and strength
Assisting with mobility, such as walking and climbing stairs
Teaching proper posture techniques

5. HOW DO I TAKE CARE OF MY NEW IMPLANT POST-SURGERY?
Most hip replacement surgeries are successful but may require a second procedure due to implant damage. These damages often result from prosthetic wear and tear over time, hip trauma, or other injuries.

A revision procedure may also be necessary if there are problems with the first surgery.

It is crucial to take care of your new implant to make it last. Your specialist can help you take steps to prevent damages and avoid what happened the first time.

6. HOW DO I PREPARE FOR THE PROCEDURE?
Your specialist will provide pre-operation instructions, such as fasting and when to stop taking certain medications. Follow them carefully to help minimize any potential problems during the procedure.

It’s also a good idea to ask your specialist how long it will take to prepare for the surgery. That way, you can plan everything before your scheduled date.

08/24/2023

Did you know you can prevent falls by doing the right exercises, like strength training and stretching, and even improving your balance?

After a surgical procedure, Jerry took part in a proven, evidence-based falls prevention program just like the one at Personalized Orthopedics of the Palm Beaches.

Thanks to the progress he made, Jerry and his partner Linda are finally able to dance again. 🕺

Watch Jerry’s inspiring story below. 🎥👏❤️

https://bit.ly/Jerrys-Falls-Prevention-Story

Palm Beach Post - Investigations Palm Beach Illustrated National Council on Aging Florida Healthy Seniors Florida Seniors Florida Senior Living Association South Florida Sun Sentinel Boca Raton Observer magazine

08/18/2023

A common complaint for many Americans of all ages is knee pain. Causes of knee pain can come from a sustained injury to arthritis and other conditions. Knee pain can be minimal to acute, depending on the severity of the knee joint’s damage.

Persistent knee pain can negatively affect your life and long-term health. If it worsens without medical intervention, it can develop into a lifelong disability. When knee pain becomes debilitating, it might be time to explore surgical options to find relief.
Knee replacement, also called knee arthroplasty, is a surgical treatment focusing on removing and replacing damaged parts of the knee.

The afflicted part of the knee joint is replaced by a metal or plastic part. The prosthetic is inserted between the softer central parts of the surrounding bones.

Knee pain from osteoarthritis is a common reason to undergo knee replacement surgery. This condition involves the degeneration of the connective tissue in the knee joint. An estimated 30% of the American population has knee osteoarthritis.

People who suffer from a severe knee injury from an accident or sports may also be candidates for this treatment option.
There are two different types of knee replacement surgery:

PARTIAL KNEE REPLACEMENT
When the damage to the knee is confined to one compartment, your physician may recommend you for partial knee replacement. People with medial or lateral knee osteoarthritis are often candidates for partial knee replacement.

Compared to total knee replacement, this treatment option better preserves the knee’s function and range of motion. Less blood is present during surgery. Recovery time is also quicker.

Partial knee replacement is often done on younger patients, but older patients can still be eligible for this treatment. It also has less recovery time compared to total knee replacement.

TOTAL KNEE REPLACEMENT
Total knee replacement surgery occurs when the entire knee joint is damaged and needs to be replaced. The ends of the femur (thighbone) and the tibia (shinbone) will be reshaped for the prosthetic joint.

Your physician will need to examine your knee before recommending either of the knee replacement options. They will check for your knee’s health, mobility, and stability. They will also check the extent of the knee’s damage through imaging tests,

BENEFITS OF KNEE REPLACEMENT
Debilitating knee pain can significantly influence your day-to-day routine. Knee replacement surgery can alleviate pain when non-surgical options no longer work. Patients restore and improve their mobility through knee replacement.

The treatment lasts one to two hours. It involves general anesthesia or a spinal block that numbs the lower half of your body. In most cases, it is an outpatient treatment. However, hospital stay depends on a case-by-case basis.

Recovery comprises rest and scheduled prescription drugs such as blood thinners. After some time, you will also undergo physical therapy to increase your physical activity and exercise your knee. You can do these activities at home or at a treatment facility.

ARE THERE RISKS TO KNEE REPLACEMENT
Like any surgical treatment, there are risks to consider before committing to knee replacement surgery. Some of these risks are:

Nerve damage from the new prosthetic
Infection originating from the incision site or in the deeper tissue
Blood clots may start in the leg but spread to the rest of the body
Incompatible prosthetic
Proper preparation and caution before, during, and after knee replacement surgery can help mitigate any risks. Talk to your healthcare provider for specialized instructions on knee replacement treatment and recovery.

WHEN TO SEE YOUR DOCTOR FOR KNEE REPLACEMENT
Having an informed discussion with your physician can help you determine whether this treatment is right for you. The right prosthetic and knee replacement option is chosen based on weight, age, overall health, and other factors.

For most patients, knee replacement surgery can last as long as 15 to 20 years. Keeping up with a healthy lifestyle is essential in prolonging and maintaining the effects of your knee replacement.

KNEE REPLACEMENT IN PALM BEACH COUNTY, FL
At Personalized Orthopedics of Palm Beach, we understand the debilitating impact that knee pain can have on your quality of life. That’s why we offer state-of-the-art outpatient knee surgery using the latest surgical techniques and equipment. Our skilled and experienced team of orthopedic surgeons operates in a sterile and safe environment, ensuring that our patients receive the highest quality of care possible. With personalized treatment plans tailored to fit each patient’s unique needs, we are committed to delivering successful outcomes and getting our patients back on their feet and daily activities as soon as possible.

To learn more about our services and how we can help you, call us today at (561) 733-5888

08/16/2023

You use your hands for almost all day-to-day activities, and that’s why taking good care of them is crucial. When you sustain an injury or develop an illness, your hand’s ability to function can be affected. Mild to moderate conditions can resolve with home remedies and nonsurgical treatments. However, surgery may be necessary to relieve the symptoms of severe injuries or diseases.

1. WHEN YOU HAVE A SEVERE INJURY OR CONDITION
Severe injuries and diseases may require surgical intervention to repair the affected area. In some cases, surgery may also be necessary to reduce long-term pain or disability.

Some examples of these conditions are:

Severe fractures
Joint damage
Tendon damage
Nerve compression
Ganglion cysts
2. WHEN NONSURGICAL TREATMENTS ARE NOT ENOUGH
Surgery may be the only option to restore function and reduce pain if nonsurgical treatments do not relieve your symptoms.

Additionally, repetitive motion injuries like carpal tunnel syndrome can worsen over time if left untreated. In these cases, surgery may be necessary to prevent further damage or disability.

3. WHEN YOU HAVE CHRONIC PAIN
Surgery may reduce discomfort if your hand injury or condition has been causing chronic pain.

For example, surgical procedures can help with severe cases of osteoarthritis or rheumatoid arthritis. Depending on the surgery, it can reduce joint pain and allow for better mobility.

4. WHEN YOUR CONDITION INTERFERES WITH DAILY ACTIVITIES
An injury or illness can make it difficult to complete everyday tasks like writing, typing, or using tools. Surgery may benefit you if your hand condition affects your quality of life and limits your abilities.

It could restore function to your affected hand and let you do the things that make up a normal lifestyle.

5. WHEN YOU NEED TO RESTORE FUNCTION AND MOBILITY
Surgery may restore function if you’re dealing with an injury or condition that has limited the movement of your hand. Depending on the type of procedure, it can help improve the following:

Dexterity
Strength
Range of motion
Many hand surgeries are minimally invasive, meaning they only require smaller incisions and less recovery time than traditional surgery.

6. WHEN YOU NEED TO PREVENT FURTHER DAMAGE
For severe cases of carpal tunnel syndrome or tendonitis, surgery may be the only way to stop the progression of damage.

It can also lessen symptoms, correct deformities, reduce swelling, or repair injured tendons and ligaments.

CONSULTING YOUR DOCTOR ABOUT HAND SURGERY
When it comes to hand surgery, you should never take the decision lightly. Speak with Dr. Tucker to ensure a surgical procedure is best for you. She will discuss the potential risks and benefits of any surgery before it’s undertaken to help you make an informed decision.

She will perform different tests to ensure you are fit for the procedure and will also consider your medical history, lifestyle, and other factors that may affect the surgery.

Remember that no two cases are alike, and there may be another course of treatment depending on your condition.