Hippocratic Medicine

By Dr. Regina Hillsman

Although the history of medicine dates back to the use of herbs during pre-historic times, one figure stands alone as one of the greatest contributors to the modern science and art of medicine: the ancient Greek physician known as Hippocrates. Widely considered the father of Western medicine, Hippocrates lived in the Age of Pericles during the 400s and 300s B.C. Hippocrates also played an integral role in the creation of the Hippocratic school of medicine, which established medicine as a profession and set it apart from fields such as philosophy and theology.

Among the first to believe that illness was not the result of superstition of the anger of the gods, Hippocrates sought to separate medicine from religion. By instead looking at external factors such as habits, diet, and environment, Hippocrates was one of the first physicians to exclude mystical causes when evaluating an illness. During his life, Hippocrates made a number of important contributions to medicine. Throughout the majority of his work, Hippocrates stressed the importance of discipline and rigorous training, placing a special emphasis on the practices of observation and documentation still in use today. Often credited with the discovery of clubbing fingers as a symptom of lung cancer and heart disease, Hippocrates also characterized illnesses based on their pathology, using terms such as acute, endemic, epidemic, and chronic.

Hippocrates made significant discoveries in the field of chest surgery and performed a large amount of research into the causes and treatment of hemorrhoids. Although Hippocrates made a number of significant contributions to the practice of medicine, he is also famous for his doctrine of humorism. According to the tenets of humorism, disease in the body was a direct result of imbalance in the four humors of the body: yellow bile, black bile, phlegm, and blood. Hippocrates also related humors to the four seasons and the elements of earth, air, fire, and water. Although many aspects of humorism fell out of favor with medical scholars in later years, Hippocratic therapy focused on patient-centered care and the importance of the body’s natural healing processes.

By Dr. Regina Hillsman

Treating ACL Injuries

By Dr. Regina O. Hillsman

As a Connecticut-based private practice physician and orthopaedic surgeon with more than 30 years experience in the field, I offer specialized care for sports, work, and arthritis-related injuries. One type of injury I offer extensive professional experience repairing is torn anterior cruciate ligaments (ACL) of the knee.

As one of the four primary ligaments surrounding the knee joint, the ACL plays a critical role in ensuring unimpeded, proper movement of the knees. More than the other surrounding ligaments, the ACL acts as a knee stabilizer. ACL injuries range from small tears to severe cases where the ligament has been completely torn. They are particularly common in contact sports such as football, where a player may be planted in one direction and receive a side hit or tackle from another. Other sports such as skiing, martial arts, and basketball require short, sudden shifts in the knee position which commonly results in ACL injuries. ACL tears are often accompanied by a sharp popping sound and subsequent swelling and instability when standing on the affected leg. Interestingly, studies have found women to be more susceptible to ACL injuries due to a combination of differences in ligament strength, unique movement patterns, and hormone variations.

There are non-surgical healing options available for ACL injuries; by making lifestyle changes that minimize wear on the knee joints, many people allow the tendon to heal on its own. This “conservative management” strategy makes use of a knee brace and regular guided physical therapy sessions. ACL surgery is generally recommended for individuals who engage in athletic activities as a vocation or profession. While the other tendons and ligaments often compensate for a torn ACL to some degree, if the condition persists other knee injuries are much more likely.

For those requiring ACL surgery, I reconstruct the torn ACL either utilizing portions of the patient`s patellar tendon, hamstring tendon, or through donor grafts. While utilizing the patellar tendon allows for bone-to-bone healing, thus providing the highest-security graft, it often results in persistent knee pain. The hamstring tendon graft creates fewer disturbances and less resulting pain, but lacks stability to an extent. While donor tissue grafts are increasingly common, the sterilization process kills living cells of the graft, resulting in a longer and less predictable healing process.

For those who regularly engage in high-impact activities but have not yet developed significant ACL injuries, I recommend undertaking preventative neuromuscular training that improves muscle strength, balance, and instills proper movement habits. Visit my website at drhillsman.org to learn more about the orthopaedic services we offer children and active adults.

Emergency Room Visits: What You Need to Know, Part 1

By Dr. Regina Hillsman

A trip to the emergency room is always traumatic, but there are steps you can take to smooth out the process.

1. Know Your Health Care Provider’s Toll-Free Line Sometimes the necessity of an ER visit is not immediately transparent. Perhaps you are experiencing symptoms that are cause for concern but do not seem cause for great concern. In such cases, make sure you have easy access to your healthcare provider’s after-hours toll-free number. Calling will put you in touch with a nurse who can diagnose your symptoms and help determine whether a trip to the emergency room is necessary. The toll-free number can be found on your provider’s website, as well as on the back of your healthcare card.

2. Understand ER Areas Many emergency rooms are divided into different sections: trauma, pediatric, observation, and others. In emergencies, panic often clouds our minds and obscures judgment; researching your hospital’s emergency room layout ahead of time makes for one less item to worry about if you need to go to the ER.

3. Organize Emergency Data ER physicians need to know certain information, such as patient allergies, current medications, health insurance plans, and chronic conditions. Gathering such data when an emergency takes place can waste precious time. Therefore, buy a folder, fill it with copies of all your emergency information, and keep it in an easily accessible place so you can quickly retrieve it in case of an emergency.

4. Be Patient Unless you have suffered severe trauma, most emergency rooms will enforce a routine that entails you being assessed, having your vital signs measured, and being directed to a waiting area where you and other patients will be called in order of urgency. Cooperating with the triage nurse who examines you will expedite the process.

5. Visit the Same Hospital If you suffer an emergency away from home, you should visit the nearest ER location. But when you are close to your home base, try to visit your regular hospital, as the doctors and staff there have access to your medical chart and other information collected over the course of previous visits.

By Dr. Regina Hillsman

Emergency Room Visits: What You Need to Know, Part 2

By Dr. Regina Hillsman

This set of tips for emergency room visits concludes with several more pointers.

6. Research the ER Staff Every ER is staffed differently. Some ERs rotate physicians, while others only employ board-certified doctors who specialize in emergency treatment. If you wish to know more about the staff of your local ER, visit the hospital website, and search for ER physician biographies.

7. Know Your Health Plan Health plans often seem labyrinthine and enact very specific terms and conditions, depending on what type of emergency care you require. If you are able, ask an ER staff member about out-of-pocket costs and what exactly your insurance will cover.

8. Ask Questions ER staff members are quite busy and focused on their work, but they also understand that people visiting the ER are anxious. If you have questions, do not hesitate to ask them. Even if your physician cannot answer them, other nurses or doctors will make time to talk to you as soon as they can.

9. Keep Your Discharge Instructions Before being discharged from the ER, make sure you have all of your post-visit instructions, such as how to take care of yourself, treatment plans, medication dosages, and so forth. Organize these papers as you receive them, and make sure to take the packet with you before going home.

10. Be Prepared to Wait Just as ERs assess patients in order of urgency, it can take time to be admitted to a hospital room, should it be required. Be tolerant, and understand that the ER staff has many other patients to care for, as well.

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